Individual provider · Type 1 NPI

Jackie Church Ii

Physical Therapy Assistant · Edgerton, WI

NPI number 1104029362 Active

Practice location

313 Stoughton Rd
Edgerton, WI 53534-1132

Call (608) 884-1390 Map

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X783-019 (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 …

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About NPI 1104029362

Jackie Church Ii's National Provider Identifier is 1104029362, issued on Jun 6, 2007. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Edgerton, WI. The record was last updated on Jul 8, 2007.