Individual
NATALIE LYNN EVERMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8535 19TH AVE, KENOSHA, WI 53143-6412
(262) 455-5382
Mailing address
8535 19TH AVE, KENOSHA, WI 53143-6412
(262) 455-5382
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2221
WI
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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