Jeran Marie Raivala in Superior - Physical Therapy Assistant
Jeran Marie Raivala - NPI 1922271949
Jeran Marie Raivala is a Physical Therapy Assistant in Superior, Wisconsin. Jeran Marie Raivala practices all healthcare services and medical treatments related to Physical Therapy Assistant. The NPI Number for Jeran Marie Raivala is 1922271949. The last update date is 2008-04-10.
Jeran Marie Raivala's current location address is 6630 Ogden Ave, Superior, Wisconsin. You can contact this provider via phone number 2183918788. The mailing address for Jeran Marie Raivala is 6630 Ogden Ave, Superior, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeran Marie Raivala |
|---|---|
| Address | 6630 Ogden Ave, Superior, Wisconsin |
| Phone Number | 2183918788 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LPTA |
NPI Number Detail
| NPI Number | 1922271949 |
|---|---|
| Provider Enumeration Date | 2008-04-10 |
| Last Updated Date | 2008-04-10 |
Provider Mailing Address Detail
| Address | 6630 Ogden Ave |
|---|---|
| City | Superior |
| State | Wisconsin (WI) |
| Post Code | 548806056 |
| Phone Number | 2183918788 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physical Therapy Assistant |
|---|---|
| Taxonomy | 225200000X |
| Licence No | 1169-019 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PENDING | WI | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Jeran Marie Raivala by the Centers for Medicare & Medicaid Services?
The Jeran Marie Raivala has been issued the NPI (National Provider Identifier) 1922271949. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Jeran Marie Raivala's facilities are geographically located?
The facilities of Jeran Marie Raivala are physically situated at the following location: 6630 Ogden Ave, Superior, WI, 548806056.
What is the area of specialization for Jeran Marie Raivala, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jeran Marie Raivala is Physical Therapy Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 225200000X.
When was the Jeran Marie Raivala's 1922271949 issued?
The Jeran Marie Raivala's 1922271949 was issued on 2008-04-10.
As of what date were the details pertaining to Jeran Marie Raivala last refreshed?
The information related to the Jeran Marie Raivala, including its address, specialty, and other relevant details, was last updated on 2008-04-10.