Individual
CATIE FERN PONTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
270 RIDGE RD, WALWORTH, WI 53184-9526
(262) 275-2317
Mailing address
W4929 PADDOCK DR, ELKHORN, WI 53121-3106
(414) 687-9526
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1652-019
WI
Other
Enumeration date
03/21/2012
Last updated
08/27/2012
About Stedi
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