Mary Bush
Individual provider Active NPI Physical Therapy Assistant · Marinette, WI
NPI 1508972704 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508972704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 553-19 (WI)
- Practice address
- 831 Pine Beach Rd
Marinette, WI 54143-4225 - Phone
- (715) 732-5796
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 553-19 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RG-Rhinelander, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 553-19 | WI | Yes |
Addresses
Primary practice location
831 Pine Beach Rd
Marinette, WI 54143-4225
Mailing address
N1961 Shore Dr
Marinette, WI 54143-9213
Phone (715) 735-3982
Other providers in Marinette, WI
- Bruce J Barrette DDS SC
- Jacob Brugger
- Kirsten J Buck
- Amber M Buelteman
- Kayley Bulin
- Derek J Butler
- Katheryn A Button
- Lynn M Caelwaerts
- Katherine Margaret Callies
- William Lyman Camp Jr.
All providers in Marinette, WI · Physical Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.