Audra Hazelberg, PT, DPT
Individual provider Active NPI Physical Therapist · Ripon, WI
NPI 1326397191 · NPPES record last updated Sep 7, 2012
Key facts
- NPI
- 1326397191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11991-24 (WI)
- Practice address
- 933 Newbury St
Ripon, WI 54971-1730 - Phone
- (920) 748-9138
- NPI assigned
- Sep 7, 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
| License | State | Type | Specialty |
|---|---|---|---|
| 11991-24 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11991-24 | WI | Yes |
Addresses
Primary practice location
933 Newbury St
Ripon, WI 54971-1730
Mailing address
933 Newbury St
Ripon, WI 54971-1730
Phone (920) 748-9138
Other names
- Audra Voga
Other providers in Ripon, WI
- Carla Gunnink
- Connor Hanson
- Wendy Lynn Hanson
- Joe Warren Hatcher
- Elizabeth Marie Hayes
- Joseph D Heckenkamp
- Sarah Ann Heyn
- Amanda J Hiemstra
- Hillside Dental Associates
- Angela Hoffman
All providers in Ripon, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2012. 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.