Pellerin-Goll, Judith K

Pellerin-Goll, Judith K is an individual health care provider with primary practice located at 403 Cross Country Rd , Verona WI 53593-1909. 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. Pellerin-Goll, Judith K can be contacted via phone (608) 848-5231.

Contact Information

Primary practice address
403 Cross Country Rd Verona WI 53593-1909
Phone: (608) 848-5231
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4690-024 Wisconsin

Profile Details

NPI number 1902849144
LBN Legal business name Pellerin-Goll, Judith K
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Oct 23rd, 2012 - about 14 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 1902849144 NPPES
Wisconsin MEDICAID 40340100

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