Provider Demographics
NPI:1427225762
Name:WEISS, BILLIE JOY (PTA)
Entity Type:Individual
Prefix:MRS
First Name:BILLIE
Middle Name:JOY
Last Name:WEISS
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 1:403 E LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-1219
Mailing Address - Country:US
Mailing Address - Phone:608-957-4744
Mailing Address - Fax:
Practice Address - Street 1:403 E LINCOLN ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-1219
Practice Address - Country:US
Practice Address - Phone:608-957-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI979-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant