Soukup, Betsy M

Soukup, Betsy M is an individual health care provider with primary practice located at 725 Butler Avenue , Winnebago WI 54985-0010. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Soukup, Betsy M can be contacted via phone (920) 235-5100.

Contact Information

Primary practice address
725 Butler Avenue Winnebago WI 54985-0010
Phone: (920) 235-5100
Fax: (920) 233-7352
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 714019 Wisconsin

Profile Details

NPI number 1376699314
LBN Legal business name Soukup, Betsy M
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Jul 8th, 2007 - about 18 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 1376699314 NPPES
Wisconsin MEDICAID 40159400

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