Provider Demographics
NPI:1346533007
Name:MCCREARY, ERIN E (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:E
Last Name:MCCREARY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 260TH AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54829-9384
Mailing Address - Country:US
Mailing Address - Phone:715-822-3631
Mailing Address - Fax:
Practice Address - Street 1:210 E PARK AVE
Practice Address - Street 2:
Practice Address - City:LUCK
Practice Address - State:WI
Practice Address - Zip Code:54853-9066
Practice Address - Country:US
Practice Address - Phone:715-472-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI844-192251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics