Individual
VICKIE L ERNST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
N87W17309 MAIN ST, MENOMONEE FALLS, WI 53051-2760
(262) 257-4740
Mailing address
N87W17309 MAIN ST, MENOMONEE FALLS, WI 53051-2760
(262) 257-4740
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
117-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40356500
—
WI
Enumeration date
05/10/2008
Last updated
05/10/2008
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