Individual
MARY ELLEN EWANOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2501 W BELTLINE HWY STE 601, MADISON, WI 53713-2309
(608) 260-6004
(608) 288-6496
Mailing address
2501 W BELTLINE HWY STE 601, MADISON, WI 53713-2309
(608) 260-6004
(608) 288-6496
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043497324
—
WI
Enumeration date
01/29/2008
Last updated
11/11/2020
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