Spencer, Mara M.

Spencer, Mara M. is an individual health care provider with primary practice located at 14555 W National Ave Ste. 135, New Berlin WI 53151-4494. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Spencer, Mara M. can be contacted via phone (262) 827-3180.

Contact Information

Primary practice address
14555 W National Ave Ste. 135 New Berlin WI 53151-4494
Phone: (262) 827-3180
Fax: (262) 827-3180
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5696-024 Wisconsin

Profile Details

NPI number 1063563286
LBN Legal business name Spencer, Mara M.
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 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 1063563286 NPPES
Wisconsin Other 5696-024 STATE LICENSE

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