Individual
MRS. CORALIE J BOURCIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1970 NAVAJO ST, RHINELANDER, WI 54501-8890
(715) 420-0728
Mailing address
3525 OLD OAK TRL, RHINELANDER, WI 54501-8365
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
647-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100012286
—
WI
Enumeration date
05/07/2008
Last updated
02/18/2021
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