Individual
CHARLENE RENEE PUSKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 267-6000
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 267-6000
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
4186-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36124000
—
WI
Enumeration date
12/05/2006
Last updated
07/09/2007
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