Individual
MRS. STACI CHRISTINE POLISHINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
845 S MAIN ST, FOND DU LAC, WI 54935-6174
(920) 322-0447
(920) 322-1362
Mailing address
845 S MAIN ST, FOND DU LAC, WI 54935-6174
(920) 322-0447
(920) 322-1362
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
375019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40293200
—
WI
Enumeration date
11/30/2006
Last updated
08/13/2019
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