Provider Demographics
NPI:1841617222
Name:NETT, BARBARA M
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:NETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 26TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-3851
Mailing Address - Country:US
Mailing Address - Phone:218-591-5201
Mailing Address - Fax:
Practice Address - Street 1:804 26TH AVE E
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-3851
Practice Address - Country:US
Practice Address - Phone:218-591-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIA1703225200000X
MNA1703225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant