Organization
JULIE DIETERLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE MARY DIETERLE P.T. (OWNER)
(608) 231-3678
Entity
Organization
Contact information
Practice address
330 S WHITNEY WAY, SUITE 202, MADISON, WI 53705-4638
(608) 231-3678
(608) 231-1856
Mailing address
330 S WHITNEY WAY, SUITE 202, MADISON, WI 53705-4638
(608) 231-3678
(608) 231-1856
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
953-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40132500
—
WI
Enumeration date
07/22/2006
Last updated
08/22/2020
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