MEDICARE: MS. JANE LOUISE STROEDE 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
1	225200000X	Physical Therapy Assistant	157-019	WI

General Provider Information

NPI Number	:	1427292275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANE LOUISE STROEDE PTA

Provider Business Mailing Address
First Line	:	2802 WALTON COMMONS WEST
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53718
Country	:	US
Telephone Number	:	608-241-6933
Fax Number	:	866-553-0864

Provider Business Practice Location Address
First Line	:	2802 WALTON COMMONS WEST
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53718
Country	:	US
Telephone Number	:	608-241-6933
Fax Number	:	866-553-0864

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	04/23/2009

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