Elizabeth Gust

Individual provider Active NPI Physical Therapist · Westfield, WI

NPI 1184007650 · NPPES record last updated Jul 2, 2015

Key facts

NPI
1184007650
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
13176-024 (WI)
Practice address
211 N Pioneer Park Rd
Westfield, WI 53964
Phone
(608) 296-2225
NPI assigned
Jul 2, 2015
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)
Yes

State licenses

LicenseStateTypeSpecialty
13176-024WIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13176-024 WI Yes

Addresses

Primary practice location

211 N Pioneer Park Rd
Westfield, WI 53964

Mailing address

2639 New Pinery Rd
Suite 2
Portage, WI 53901-1110

Other providers in Westfield, WI

All providers in Westfield, WI · Physical Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.