Lavonne Diane Gustafson in Iron River - Physical Therapy Assistant
Lavonne Diane Gustafson - NPI 1083888705
Lavonne Diane Gustafson is a Physical Therapy Assistant in Iron River, Wisconsin. Lavonne Diane Gustafson practices all healthcare services and medical treatments related to Physical Therapy Assistant. The NPI Number for Lavonne Diane Gustafson is 1083888705. The last update date is 2008-04-14.
Lavonne Diane Gustafson's current location address is 62277 Delta Lake Rd, Iron River, Wisconsin. You can contact this provider via phone number 7153725659. The mailing address for Lavonne Diane Gustafson is 62277 Delta Lake Rd, Iron River, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lavonne Diane Gustafson |
|---|---|
| Address | 62277 Delta Lake Rd, Iron River, Wisconsin |
| Phone Number | 7153725659 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PTA |
NPI Number Detail
| NPI Number | 1083888705 |
|---|---|
| Provider Enumeration Date | 2008-04-14 |
| Last Updated Date | 2008-04-14 |
Provider Mailing Address Detail
| Address | 62277 Delta Lake Rd |
|---|---|
| City | Iron River |
| State | Wisconsin (WI) |
| Post Code | 548474570 |
| Phone Number | 7153725659 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physical Therapy Assistant |
|---|---|
| Taxonomy | 225200000X |
| Licence No | 1343-019 |
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Definition: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Post |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Lavonne Diane Gustafson by the Centers for Medicare & Medicaid Services?
The Lavonne Diane Gustafson has been issued the NPI (National Provider Identifier) 1083888705, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Lavonne Diane Gustafson is physically located?
The Lavonne Diane Gustafson is physically situated at the following address: 62277 Delta Lake Rd, Iron River, WI, 548474570.
What is Lavonne Diane Gustafson's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Lavonne Diane Gustafson's specialized field of practice is Physical Therapy Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 225200000X.
On what date was the 1083888705 assigned to Lavonne Diane Gustafson?
The Lavonne Diane Gustafson was issued its 1083888705 on 2008-04-14, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Lavonne Diane Gustafson most recently updated or revised?
The details related to Lavonne Diane Gustafson, including its address, specialty, and other relevant information, were last updated or revised on 2008-04-14.