Organization
MS. ELLE HUCK, PTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM H. LETSOM P.T. (PRESIDENT)
(262) 694-3977
Entity
Organization
Contact information
Practice address
7201 GREEN BAY RD, KENOSHA, WI 53142-3532
(262) 694-3977
(262) 694-5648
Mailing address
7201 GREEN BAY RD, KENOSHA, WI 53142-3532
(262) 694-3977
(262) 694-5648
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2155-19
WI
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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