Individual
MRS. KAYLYNN RUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
N7135 ROCKY KNOLL PKWY, PLYMOUTH, WI 53073-3103
(920) 449-1254
Mailing address
W6186 CTY RD, PLYMOUTH, WI 53073-4639
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
13198-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065219
—
WI
Enumeration date
11/17/2016
Last updated
03/17/2018
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