Gustafson, Lavonne Diane

Gustafson, Lavonne Diane is an sole proprietor health care provider with primary practice located at 62277 Delta Lake Rd , Iron River WI 54847-4570. 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. Gustafson, Lavonne Diane can be contacted via phone (715) 372-5659.

Contact Information

Primary practice address
62277 Delta Lake Rd Iron River WI 54847-4570
Phone: (715) 372-5659
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 1343-019 Wisconsin

Profile Details

NPI number 1083888705
LBN Legal business name Gustafson, Lavonne Diane
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 14th, 2008
Last updated Apr 14th, 2008 - about 17 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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