Individual
MS. BETHANIE HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
9809 39TH AVE, PLEASANT PRAIRIE, WI 53158-3733
(262) 925-5080
Mailing address
9809 39TH AVE STE 2, PLEASANT PRAIRIE, WI 53158-3733
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6035
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6035
PT LICENSE
OK
01
—
CP043646T
COMPACT LICENSE
WI
Enumeration date
07/06/2021
Last updated
05/23/2025
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