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Organization
JEANNE H. MATHER
Active
Organization
JEANNE H. MATHER
Active
Other names
Northern Lights Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE H MATHER (OWNER)
(715) 356-9729
Entity
Organization
Contact information
Practice address
1256 BRANDY LAKE RD, ARBOR VITAE, WI 54568-9218
(715) 356-9729
(715) 358-5209
Mailing address
PO BOX 827, 1256 BRANDY LAKE ROAD, ARBOR VITAE, WI 54568-0827
(715) 356-9729
(715) 358-5209
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
NULL
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
NULL
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41228400
—
WI
Enumeration date
05/10/2007
Last updated
07/01/2008
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