Individual
MISS RUTH L KLONOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
W5410 COUNTY ROAD C, MONTELLO, WI 53949-8096
(608) 589-5028
Mailing address
W5410 COUNTY ROAD C, MONTELLO, WI 53949-8096
(608) 589-5028
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1223-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40465900
—
WI
Enumeration date
04/07/2008
Last updated
04/08/2008
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