Kimberly B Fortney, PTA
Individual provider Active NPI Physical Therapy Assistant · Viroqua, WI
NPI 1104544709 · NPPES record last updated Aug 19, 2022
Key facts
- NPI
- 1104544709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 3279-19 (WI)
- Practice address
- 403 E Parkinson St Apt 2
Viroqua, WI 54665-1483 - Phone
- (608) 792-1185
- NPI assigned
- Aug 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3279-19 | WI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3279-19 | WI | Yes |
Addresses
Primary practice location
403 E Parkinson St Apt 2
Viroqua, WI 54665-1483
Mailing address
403 E Parkinson St Apt 2
Viroqua, WI 54665-1483
Phone (608) 792-1185
Other providers in Viroqua, WI
- William Frederick Fasching
- Katie R. Fassbinder
- James R Feltes
- Amber Lockie Ferguson
- Megan Fiorella
- Eileen M Fossum
- Thomas L Franke
- Fritsch Health Services Inc
- Kathryn M Frydenlund
- Jheri Fushianes
All providers in Viroqua, WI · Physical Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.