Individual
SHERRY WIDOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
199 HOME RD, JUNEAU, WI 53039-1401
(920) 386-3537
Mailing address
127 E ANTHONY ST, HUSTISFORD, WI 53034-9756
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
220-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40115600
—
WI
Enumeration date
09/15/2006
Last updated
07/08/2007
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