Polishinski, Staci Christine
Polishinski, Staci Christine is an individual health care provider with primary practice located at 845 S Main St , Fond Du Lac WI 54935-6174. 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. Polishinski, Staci Christine can be contacted via phone (920) 322-0447.Contact Information
Primary practice address
845 S Main St
Fond Du Lac WI 54935-6174
Phone: (920) 322-0447
Fax: (920) 322-1362
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | 375019 | Wisconsin |
Profile Details
| NPI number | 1134297070 |
|---|---|
| LBN Legal business name | Polishinski, Staci Christine |
| Credentials | Physical Therapist Assistant (PTA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2006 |
| Last updated | Aug 13th, 2019 - about 6 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 | 1134297070 | NPPES |
| Wisconsin | MEDICAID | 40293200 |
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