Individual
JULIE KAY RADTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
1625 E MAIN ST, CLINTONVILLE, WI 54929-8407
(715) 823-3135
Mailing address
N4433 COUNTY ROAD T, SHAWANO, WI 54166-6965
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
168-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40240300
—
WI
Enumeration date
05/22/2008
Last updated
05/22/2008
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