Individual provider · Type 1 NPI

Tara Herides, PTA

Physical Therapy Assistant · Wild Rose, WI

NPI number 1053877530 Active

Practice location

425 Summit St
Wild Rose, WI 54984-6804

Fax (920) 622-3655

Mailing address

N5436 Nutter St
Wild Rose, WI 54984-6752

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X2902 (WI)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1053877530

Tara Herides, PTA's National Provider Identifier is 1053877530, issued on Feb 20, 2019. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Wild Rose, WI. The record was last updated on Feb 20, 2019.