Provider Demographics
NPI:1144399023
Name:VELDEY, CAROL ANN (PTA)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:VELDEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:BLADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ELROY
Mailing Address - State:WI
Mailing Address - Zip Code:53929
Mailing Address - Country:US
Mailing Address - Phone:608-387-0429
Mailing Address - Fax:
Practice Address - Street 1:400 WATER AVE
Practice Address - Street 2:ST JOSEPHS HOSP
Practice Address - City:HILLSBORO
Practice Address - State:WI
Practice Address - Zip Code:54634
Practice Address - Country:US
Practice Address - Phone:608-489-8260
Practice Address - Fax:608-489-8193
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1091019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
V430000673361OtherDPI