Miracle, Carol Martha

Miracle, Carol Martha is an individual health care provider with primary practice located at N27W5707 Lincoln Blvd , Cedarburg WI 53012-2852. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics, which is considered as her primary health care specialty. Miracle, Carol Martha can be contacted via phone (262) 376-7676.

Contact Information

Primary practice address
N27W5707 Lincoln Blvd Cedarburg WI 53012-2852
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Geriatrics 2251G0304X 1032-024 Wisconsin

Profile Details

NPI number 1588873905
LBN Legal business name Miracle, Carol Martha
Credentials PHYSICAL THERAPIST
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2007
Last updated Jul 8th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588873905 NPPES
Wisconsin MEDICAID 40309100

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