Basic Information
| Provider Information | |||||||||
| NPI: | 1942578513 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUEHN | ||||||||
| FirstName: | ROSE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2216 16TH AVE | ||||||||
| Address2: | |||||||||
| City: | CAMERON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548229779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7157362899 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1700 W STOUT ST | ||||||||
| Address2: | |||||||||
| City: | RICE LAKE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548685000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152368100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2011 | ||||||||
| LastUpdateDate: | 12/09/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 679-19 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.