Robin Lachance, PTA

Individual provider Active NPI Physical Therapy Assistant · Bloomer, WI

NPI 1093064545 · NPPES record last updated Aug 30, 2012

Key facts

NPI
1093064545
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1924-19 (WI)
Practice address
1731 17TH Avenue
Bloomer, WI 54724
Phone
(715) 568-4669
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1924-19WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1924-19 WI Yes

Addresses

Primary practice location

1731 17TH Avenue
Bloomer, WI 54724

Mailing address

1731 17TH Avenue
Bloomer, WI 54724
Phone (715) 568-4669

Other providers in Bloomer, WI

All providers in Bloomer, WI · Physical Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.