Boldt, Trisha M

Boldt, Trisha M is an individual health care provider with primary practice located at 1630 Commanche Ave , Green Bay WI 54313-5753. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Boldt, Trisha M can be contacted via phone (920) 430-4700.

Contact Information

Primary practice address
1630 Commanche Ave Green Bay WI 54313-5753
Phone: (920) 430-4700
Fax: (920) 430-4747
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 13698-24 Wisconsin

Profile Details

NPI number 1316474893
LBN Legal business name Boldt, Trisha M
Credentials D-PT
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2017
Last updated May 16th, 2017 - about 9 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 1316474893 NPPES
Wisconsin Other 13698-24 WISCONSIN STATE LICENSE

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