Individual
REBECCA E GUILETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2253 W MASON ST, GREEN BAY, WI 54303-4706
(920) 327-7216
Mailing address
PO BOX 73041, CHICAGO, IL 60673-7041
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2375-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100161913
—
WI
Enumeration date
04/09/2021
Last updated
04/09/2024
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