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Individual

MRS. DOMINI REI HANUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1905 W. HART RD, BELOIT, WI 53511
(608) 365-7500
(608) 365-0190
Mailing address
1905 W. HART RD, BELOIT, WI 53511
(608) 365-7500
(608) 365-0190

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1526-19
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100073093
WI
05
1265593503
WI
Enumeration date
03/28/2014
Last updated
10/13/2022
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