Individual
ABBEY MISHICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1100 GATEWAY CT, WEST BEND, WI 53095-8539
(262) 673-2300
Mailing address
1100 GATEWAY CT, WEST BEND, WI 53095-8539
(262) 673-2300
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1854
WI
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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