Provider Demographics
NPI:1447229356
Name:SENORASKE, ELIZABETH M (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:M
Last Name:SENORASKE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S 2ND ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-2403
Mailing Address - Country:US
Mailing Address - Phone:715-426-7878
Mailing Address - Fax:715-426-7852
Practice Address - Street 1:215 S 2ND ST STE 10
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-2403
Practice Address - Country:US
Practice Address - Phone:715-426-7878
Practice Address - Fax:715-426-7852
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6358-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40421400Medicaid
WI1447229356Medicaid