Formanek, Robyn Marie

Formanek, Robyn Marie is an individual health care provider with primary practice located at 257 W Saint George Ave , Grantsburg WI 54840-7827. 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. Formanek, Robyn Marie can be contacted via phone (715) 463-5353.

Contact Information

Primary practice address
257 W Saint George Ave Grantsburg WI 54840-7827
Phone: (715) 463-5353
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4284-024 Wisconsin
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4963 Minnesota

Profile Details

NPI number 1619946134
LBN Legal business name Formanek, Robyn Marie
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Jul 8th, 2007 - about 19 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 1619946134 NPPES
Wisconsin MEDICAID 40197300

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