Individual
BETTY L MAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5595 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-2100
(262) 306-2128
Mailing address
WEST 3345 HIGHWAY K, RANDOM LAKE, WI 53075
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2108
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40026800
—
WI
Enumeration date
11/09/2006
Last updated
07/09/2007
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