Provider Demographics
NPI:1083641401
Name:MERGENER, PATRICIA DIANE (PT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:DIANE
Last Name:MERGENER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4901 COTTAGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716-1392
Mailing Address - Country:US
Mailing Address - Phone:608-221-1501
Mailing Address - Fax:608-223-3540
Practice Address - Street 1:4901 COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53716-1392
Practice Address - Country:US
Practice Address - Phone:608-221-1501
Practice Address - Fax:608-223-3540
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1434-0242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic