Individual
MRS. ASHA ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1518 SPRING VALLEY DR, RACINE, WI 53405
(502) 419-6927
Mailing address
1518 SPRING VALLEY DRIVE, RACINE, WI 53405
(502) 419-6927
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11375
WI
225100000X
Physical Therapist
Primary
5501012263
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383454355
ALTERNATIVE REHAB TAX ID
MI
01
—
650H217590
BCBS GROUP PIN
MI
01
—
650H225250
BCBS INDIVIDUAL PIN
MI
Enumeration date
12/08/2006
Last updated
10/03/2013
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