Individual
MARILYN ANN MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
257 W SAINT GEORGE AVE, GRANTSBURG, WI 54840-7827
(715) 463-7253
(715) 463-7351
Mailing address
257 W SAINT GEORGE AVE, GRANTSBURG, WI 54840-7827
(715) 463-7253
(715) 463-7351
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13675-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669519286
—
WI
Enumeration date
01/31/2007
Last updated
07/21/2022
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