Individual
ELIZABETH R BOURESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2915 N MEADE ST, APPLETON, WI 54911-1509
(920) 993-6837
Mailing address
2915 N MEADE ST, APPLETON, WI 54911-1509
(920) 993-6837
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1588-019
WI
Other
Enumeration date
11/11/2009
Last updated
10/08/2024
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