Individual
MRS. CAROLYN A GUALDRON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
319 N WISCONSIN ST, ELKHORN, WI 53121-1315
(262) 723-2711
Mailing address
N8123 ROSE TER, ELKHORN, WI 53121-2474
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9598-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40365300
—
WI
Enumeration date
10/11/2005
Last updated
07/08/2007
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