Individual
SUSAN IRENE GILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(715) 526-7370
Mailing address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(715) 526-7370
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3202-19
WI
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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