Individual
AUGUSTINE AVELLEYRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 S 1ST ST, MOUNT HOREB, WI 53572-1906
(608) 692-7762
Mailing address
5470 CONGRESS AVE APT 3, MADISON, WI 53718-2218
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2711-19
WI
Other
Enumeration date
04/28/2023
Last updated
04/28/2023
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