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Individual

CONNIE M GEHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1610 HOOVER ST, NEW HOLSTEIN, WI 53061-1636
(920) 898-5627
Mailing address
W4206 US HIGHWAY 151, CHILTON, WI 53014-9658

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
WI
225200000X
Physical Therapy Assistant
806-019
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36111700
WI
Enumeration date
05/09/2007
Last updated
08/28/2007
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