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COURTNEY WAGNER SOUHEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
3021 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16642-24
WI
225100000X
Physical Therapist
39352
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100273462
WI
Enumeration date
08/30/2022
Last updated
11/12/2025
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