Amy Jo Elder, PTA

Individual provider Active NPI Physical Therapy Assistant · Wonewoc, WI

NPI 1902070543 · NPPES record last updated Apr 25, 2008

Key facts

NPI
1902070543
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
251-019 (WI)
Practice address
S142 State Road 33
Wonewoc, WI 53968-9642
Phone
(608) 393-1617
Fax
(608) 524-9181
NPI assigned
Apr 15, 2008
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
251-019WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 251-019 WI Yes

Addresses

Primary practice location

S142 State Road 33
Wonewoc, WI 53968-9642

Mailing address

S142 State Road 33
Wonewoc, WI 53968-9642
Phone (608) 393-1617

Other providers in Wonewoc, WI

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

Sources for this page

Verify at the official NPI Registry.