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Individual

JULIE KIRST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3605 STEWART AVE, WAUSAU, WI 54401
(715) 847-3796
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3707
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40158300
WI
Enumeration date
08/31/2006
Last updated
03/12/2014
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