Mazza, Colleen Marie
Mazza, Colleen Marie is an sole proprietor health care provider with primary practice located at 1610 Hoover St , New Holstein WI 53061-1636. She recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Mazza, Colleen Marie can be contacted via phone (920) 898-5627.Contact Information
Primary practice address
1610 Hoover St
New Holstein WI 53061-1636
Phone: (920) 898-5627
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 3424-024 | Wisconsin |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics | 2251G0304X | 3424-024 | Wisconsin |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X | 3424-024 | Wisconsin |
Profile Details
| NPI number | 1417161464 |
|---|---|
| LBN Legal business name | Mazza, Colleen Marie |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 9th, 2007 |
| Last updated | Aug 29th, 2007 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417161464 | NPPES |
| Wisconsin | MEDICAID | 40139600 |
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