Individual
MARY GILSDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2801 SOUTH WEBSTER AVENUE, GREEN BAY, WI 54301
(920) 337-1122
(920) 964-0550
Mailing address
PO BOX 1324, GREEN BAY, WI 54305-1324
(920) 337-1122
(920) 964-0550
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3089-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40174500
—
WI
Enumeration date
03/21/2007
Last updated
11/28/2017
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