Individual
MS. MARY ELLEN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
5505 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-4280
(262) 306-2689
Mailing address
5505 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-4280
(262) 306-2689
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
851-24
WI
Other
Enumeration date
12/16/2009
Last updated
12/16/2009
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