Amy Vertz

Individual provider Active NPI Physical Therapy Assistant · Dousman, WI

NPI 1356749519 · NPPES record last updated Dec 19, 2014

Key facts

NPI
1356749519
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2191-19 (WI)
Practice address
183 County Road D
Dousman, WI 53118-8737
Phone
(262) 719-6167
NPI assigned
Dec 19, 2014
Sex
Female
Sole proprietor
Yes

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
2191-19WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2191-19 WI Yes

Addresses

Primary practice location

183 County Road D
Dousman, WI 53118-8737

Mailing address

183 County Road D
Dousman, WI 53118-8737
Phone (262) 719-6167

Other providers in Dousman, WI

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

Sources for this page

Verify at the official NPI Registry.