Individual
MS. MARY LOU JANE BAUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
507 S MONROE ST, LANCASTER, WI 53813-2054
(608) 723-3236
(608) 723-3379
Mailing address
507 S MONROE ST, LANCASTER, WI 53813-2054
(608) 723-3236
(608) 723-3379
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
916.024
WI
282NR1301X
Rural Acute Care Hospital
Primary
916-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40086800
—
WI
Enumeration date
09/24/2008
Last updated
02/16/2009
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