Mason Froeba, PTA
Individual provider Active NPI Physical Therapy Assistant · Merrill, WI
NPI 1114409778 · NPPES record last updated Aug 30, 2018
Key facts
- NPI
- 1114409778
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2817-19 (WI)
- Practice address
- 2100 E 6TH St
Merrill, WI 54452-3107 - Phone
- (715) 255-3013
- NPI assigned
- Aug 30, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 2817-19 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RG-Rhinelander, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2817-19 | WI | Yes |
Addresses
Primary practice location
2100 E 6TH St
Merrill, WI 54452-3107
Mailing address
500 W Elm Dr
Loyal, WI 54446-9517
Phone (715) 255-3013
Other providers in Merrill, WI
- Family Dentistry
- Family Foot and Ankle Clinic LLC
- Julie Fehr
- Mary Fischer
- Jennifer Lind Freyer
- Ann L Fullington
- Steven Gasper
- Susan Marie George
- Anthony A. Gerlach
- Tasha Marie Gleason
All providers in Merrill, 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 30, 2018. 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.