Marcello, Diane Kay

Marcello, Diane Kay is an individual health care provider with primary practice located at 211 S Curtis St , Lake Geneva WI 53147-2052. 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. Marcello, Diane Kay can be contacted via phone (262) 248-3145.

Contact Information

Primary practice address
211 S Curtis St Lake Geneva WI 53147-2052
Phone: (262) 248-3145
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 962-19 Wisconsin

Profile Details

NPI number 1316170814
LBN Legal business name Marcello, Diane Kay
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2009
Last updated Oct 15th, 2012 - about 13 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 1316170814 NPPES
Wisconsin MEDICAID 1316170814

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