Sheryl Lois Gavin, PTA
Individual provider Active NPI Physical Therapy Assistant · Thorp, WI
NPI 1629422712 · NPPES record last updated Apr 14, 2016
Key facts
- NPI
- 1629422712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 805-019 (WI)
- Practice address
- 206 W Prospect St
Thorp, WI 54771-9303 - Phone
- (715) 669-5321
- NPI assigned
- Apr 14, 2016
- 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 |
|---|---|---|---|
| 805-019 | WI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 805-019 | WI | Yes |
Addresses
Primary practice location
206 W Prospect St
Thorp, WI 54771-9303
Mailing address
224 W Ginty St
Cadott, WI 54727-9100
Phone (715) 289-4152
Other names
- Sheryl Lois Gustum
Other providers in Thorp, WI
- Dhcsc
- Dr.S Melcher and Sprague
- DRS Melcher and Sprague Optometrists SC
- Aleyna Edblom
- Michael A. Einhorn
- Peter P Gintner
- Michelle M Goodman
- Hank'S Furniture & Carpeting, Inc
- Hickok Rehab Services LLC
- Homeward Hearts Home Care
All providers in Thorp, 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 Apr 14, 2016. 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.