Individual
MRS. CARMEN RACHELLE VAN HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5700 W LAYTON AVE, GREENFIELD, WI 53220-4016
(414) 281-7200
Mailing address
5700 W LAYTON AVE, GREENFIELD, WI 53220-4016
(414) 281-7200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10108-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40403100
—
WI
Enumeration date
04/11/2008
Last updated
04/11/2008
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