Individual
NANCY GOETHLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10775 NYMAN AVE, HAYWARD, WI 54843-6484
(715) 634-2202
Mailing address
10775 NYMAN AVE, HAYWARD, WI 54843-6484
(715) 634-2202
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1108-19
WI
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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