Rita Ana Latimer, PT

Individual provider Active NPI Physical Therapist · Combined Locks, WI

NPI 1205100799 · NPPES record last updated Feb 29, 2012

Key facts

NPI
1205100799
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
11836024 (WI)
Practice address
526 Rusch Dr
Combined Locks, WI 54113-1428
Phone
(920) 205-8697
NPI assigned
Feb 29, 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
11836024WIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11836024 WI Yes

Addresses

Primary practice location

526 Rusch Dr
Combined Locks, WI 54113-1428

Mailing address

526 Rusch Dr
Combined Locks, WI 54113-1428
Phone (920) 205-8697

Other providers in Combined Locks, WI

All providers in Combined Locks, WI · Physical Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.