Teresa Denise Bare-Inman

Individual provider Active NPI Physical Therapy Assistant · Prairie Du Sac, WI

NPI 1780249243 · NPPES record last updated May 9, 2019

Key facts

NPI
1780249243
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1952-19 (WI)
Practice address
260 26TH St
Prairie Du Sac, WI 53578-2203
Phone
(608) 643-3311
NPI assigned
May 9, 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
1952-19WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1952-19 WI Yes

Addresses

Primary practice location

260 26TH St
Prairie Du Sac, WI 53578-2203

Mailing address

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-3311

Other providers in Prairie Du Sac, WI

All providers in Prairie Du Sac, WI · Physical Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.