Individual
JUDITH ANN DISRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7710 S BROOKLINE DR, MADISON, WI 53719-3511
(608) 833-2017
Mailing address
2620 WAUNONA WAY, MADISON, WI 53713-1525
(608) 223-1459
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1513-19
WI
Other
Enumeration date
07/25/2008
Last updated
05/11/2015
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