Individual
MRS. TERRY SUE BETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54308-8900
(920) 288-4700
Mailing address
PO BOX 8900, 2845 GREENBRIER RD, GREEN BAY, WI 54308-8900
(920) 288-4710
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
136019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40325500
—
WI
Enumeration date
10/30/2007
Last updated
10/30/2007
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