Betsy Follis

Individual provider Active NPI Physical Therapy Assistant · South Range, WI

NPI 1730596172 · NPPES record last updated Jul 17, 2014

Key facts

NPI
1730596172
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1184-19 (WI)
Practice address
8274 E San Rd
South Range, WI 54874-8621
Phone
(715) 398-3523
Fax
(715) 374-2236
NPI assigned
Jul 17, 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
1184-19WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1184-19 WI Yes

Addresses

Primary practice location

8274 E San Rd
South Range, WI 54874-8621

Mailing address

8274 E San Rd
South Range, WI 54874-8621
Phone (715) 398-3523

Other providers in South Range, WI

All providers in South Range, WI · Physical Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.