Individual
MISS JULIE MARIE VANHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
501 N LAKE ST, PESHTIGO, WI 54157-1013
(715) 582-3962
(715) 582-0803
Mailing address
912 WIRTZ AVE, GREEN BAY, WI 54304
(920) 680-5527
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1819-19
WI
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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