Provider Demographics
NPI:1518170604
Name:PIERCE, MARGARET ANN (RPT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W8054 RICHARD RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53911-9792
Mailing Address - Country:US
Mailing Address - Phone:608-206-1255
Mailing Address - Fax:
Practice Address - Street 1:1049 N EDGE TRAIL
Practice Address - Street 2:STELLAR REHABILITATION
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1942
Practice Address - Country:US
Practice Address - Phone:608-845-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1477-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIE40009300Medicaid
WI1477-24OtherSTATE OF WISCONSIN DEPARTMENT OF SAFETY AND REGULATION