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NPI Code Detail

MEDICARE: MRS. JILL MARIE GREHN LPTA

MEDICARE: MRS. JILL MARIE GREHN LPTA
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 Assistant922019WI

General Provider Information

NPI Number : 1871760157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JILL MARIE GREHN LPTA
Provider Business Mailing Address
First Line : 1319 BEASER AVE
Second Line :
City : ASHLAND
State : WI
Zip : 54806-3614
Country : US
Telephone Number : 715-682-3468
Fax Number :
Provider Business Practice Location Address
First Line : 1319 BEASER AVE
Second Line :
City : ASHLAND
State : WI
Zip : 54806-3614
Country : US
Telephone Number : 715-682-3468
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2008
Last Update Date : 05/14/2008

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