Individual
JOYCE R EHLENFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14095
WI
2251P0200X
Pediatric Physical Therapist
070.013025
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01638671
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/06/2007
Last updated
04/26/2019
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