Taylor Husom, | |
1300 W Lincoln Ave, Port Washington, WI 53074-2098 | |
(479) 201-6098 | |
Not Available |
Full Name | Taylor Husom |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 4 Years |
Location | 1300 W Lincoln Ave, Port Washington, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629693676 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 15007 (Wisconsin) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Great Lakes Healthcare Inc | 5395079719 | 11 |
Provider Name | Aegis Group Practice Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1275073363 PECOS PAC ID: 5193036432 Enrollment ID: O20170614002978 |
Provider Name | Great Lakes Healthcare Inc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1184282618 PECOS PAC ID: 5395079719 Enrollment ID: O20190730000104 |
Mailing Address | Practice Location Address |
---|---|
Taylor Husom, 1300 W Lincoln Ave, Port Washington, WI 53074-2098 Ph: () - | Taylor Husom, 1300 W Lincoln Ave, Port Washington, WI 53074-2098 Ph: (479) 201-6098 |
Sheri L Bunyan, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1119 N Wisconsin St, Port Washington, WI 53074 Phone: 262-284-5892 | |
Brianna Rae Zimmerman, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1119 N Wisconsin St, Port Washington, WI 53074 Phone: 262-284-5892 | |
Mrs. Michele Rae Barney, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 1317 W Grand Ave, Rehab, Port Washington, WI 53074 Phone: 262-284-2261 Fax: 262-284-4641 | |
Maja Kern, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1475 W Grand Ave, Port Washington, WI 53074 Phone: 262-268-5100 | |
David Arthur Peterson, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1317 W Grand Ave, Port Washington, WI 53074 Phone: 262-284-2261 | |
Aegis Group Practice Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1330 W Lincoln Ave, Port Washington, WI 53074 Phone: 800-444-6845 | |
Breanne N Beres, DPT, ATC Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1475 W Grand Ave, Port Washington, WI 53074 Phone: 262-268-5100 |