Whitney Bird

Individual provider Active NPI Physical Therapist · Portage, WI

NPI 1629623681 · NPPES record last updated Feb 18, 2022

Key facts

NPI
1629623681
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
13313 (WI)
Practice address
2815 New Pinery Rd
Portage, WI 53901-9257
Phone
(608) 745-6290
Fax
(698) 745-6250
NPI assigned
Aug 7, 2019
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
13313WIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13313 WI Yes

Addresses

Primary practice location

2815 New Pinery Rd
Portage, WI 53901-9257

Mailing address

N140 4TH Ave
Westfield, WI 53964-8300
Phone (608) 445-9969

Other names

  • Whitney Moll Former name

Other providers in Portage, WI

All providers in Portage, WI · Physical Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.