Individual
TASHA R WHITCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4605 VALDRES SPRINGS CT, WESTON, WI 54476-4189
(715) 393-0419
Mailing address
325 MAPLE GROVE CT, STEVENS POINT, WI 54482-9284
(920) 370-2094
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1351-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36122600
—
WI
Enumeration date
05/07/2007
Last updated
10/10/2012
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