Provider Demographics
NPI:1033473541
Name:ZIEBELL, PATTI (PTA)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:
Last Name:ZIEBELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:PATTI
Other - Middle Name:
Other - Last Name:ZIELSDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4013 BEACON HILL DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-2062
Mailing Address - Country:US
Mailing Address - Phone:608-295-2654
Mailing Address - Fax:
Practice Address - Street 1:4013 BEACON HILL DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-2062
Practice Address - Country:US
Practice Address - Phone:608-295-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI459-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant