Kayla Gibbons

Individual provider Active NPI Physical Therapy Assistant · Juneau, WI

NPI 1346868296 · NPPES record last updated Jul 8, 2020

Key facts

NPI
1346868296
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2483-19 (WI)
Practice address
198 County Road DF
Juneau, WI 53039-9515
Phone
(920) 386-3548
NPI assigned
Jul 8, 2020
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
2483-19WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2483-19 WI Yes

Addresses

Primary practice location

198 County Road DF
Juneau, WI 53039-9515

Mailing address

106 S Holmen Dr Ste 2
Holmen, WI 54636-9468
Phone (608) 526-9888

Other providers in Juneau, WI

All providers in Juneau, WI · Physical Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.