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Individual

JOYCE R EHLENFELDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

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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