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Individual

MARIAH JANISCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1601 WHEELER RD, MADISON, WI 53704-7056
(608) 496-8595
Mailing address
3633 T BIRD WAY, COTTAGE GROVE, WI 53527-9462
(608) 225-9631

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2699
WI

Other

Enumeration date
10/06/2022
Last updated
10/06/2022
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