Basic Information
| Provider Information | |||||||||
| NPI: | 1902521412 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ZIEMENDORF | ||||||||
| FirstName: | ANNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 218 10TH AVE APT 227 | ||||||||
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| City: | EAU CLAIRE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 547034620 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1840 PRIDDY ST | ||||||||
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| City: | BLOOMER | ||||||||
| State: | WI | ||||||||
| PostalCode: | 547241546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7155682503 | ||||||||
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| ProviderEnumerationDate: | 10/06/2022 | ||||||||
| LastUpdateDate: | 10/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.