Individual
ANISSA JYSHAE MCGLORY-MIRABAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4187
(715) 847-2826
Mailing address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4187
(715) 847-2826
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4113-19
WI
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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