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NPI Code Detail

MEDICARE: MR. CHRISTOPHER FERSTENOU PTA

MEDICARE: MR. CHRISTOPHER FERSTENOU PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant1792-019WI

General Provider Information

NPI Number : 1215217492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER FERSTENOU PTA
Provider Business Mailing Address
First Line : 106 S HOLMEN DR
Second Line :
City : HOLMEN
State : WI
Zip : 54636-9467
Country : US
Telephone Number : 608-526-9888
Fax Number :
Provider Business Practice Location Address
First Line : 464 S SAINT JOSEPH AVE STE 100
Second Line :
City : ARCADIA
State : WI
Zip : 54612-1401
Country : US
Telephone Number : 608-323-9998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2011
Last Update Date : 08/19/2011

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