Terrie Braun-Johnson, PTA

Individual provider Active NPI Physical Therapy Assistant · Viroqua, WI

NPI 1659548014 · NPPES record last updated May 14, 2008

Key facts

NPI
1659548014
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
649-19 (WI)
Practice address
614 S Rock Ave
Viroqua, WI 54665-1936
Phone
(608) 637-2171
NPI assigned
May 14, 2008
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
649-19WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 649-19 WI Yes

Addresses

Primary practice location

614 S Rock Ave
Viroqua, WI 54665-1936

Mailing address

1004 Cardinal St NW
PO Box 235
Bangor, WI 54614-6705
Phone (608) 486-2027

Other providers in Viroqua, WI

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

Sources for this page

Verify at the official NPI Registry.