Bausch, Mary Lou Jane

Bausch, Mary Lou Jane is an sole proprietor health care provider with primary practice located at 507 S Monroe St , Lancaster WI 53813-2054. She recently has 2 registered licenses in different health care specialties including Hospitals / Rural, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Hospitals / Rural is her primary health care specialty. Bausch, Mary Lou Jane can be contacted via phone (608) 723-3236.

Contact Information

Primary practice address
507 S Monroe St Lancaster WI 53813-2054
Phone: (608) 723-3236
Fax: (608) 723-3379
Website:
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Health care specialties

SpecialtyCodeLicense #State
Hospitals / Rural 282NR1301X 916-024 Wisconsin
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 916.024 Wisconsin

Profile Details

NPI number 1467602615
LBN Legal business name Bausch, Mary Lou Jane
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2008
Last updated Feb 16th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467602615 NPPES
Wisconsin MEDICAID 40086800

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