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Individual

MRS. REBECCA ANN FUGARINO WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
3126 SKYLINE DR, HUBERTUS, WI 53033-9650
(262) 628-3450
Mailing address
3126 SKYLINE DR, HUBERTUS, WI 53033-9650
(262) 628-3450

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
261-019
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40186300
WI
Enumeration date
08/19/2007
Last updated
08/19/2007
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