Individual provider · Type 1 NPI
Lavonne Diane Gustafson, PTA
Physical Therapy Assistant · Iron River, WI
Practice location
62277 Delta Lake Rd
Iron River, WI 54847-4570
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | 1343-019 (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 …
About NPI 1083888705
Lavonne Diane Gustafson, PTA's National Provider Identifier is 1083888705, issued on Apr 14, 2008. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Iron River, WI. The record was last updated on Apr 14, 2008.