Whitney M Custer, PT | |
Bella Vista 631 Hazel St, Oshkosh, WI 54901-4600 | |
(262) 389-5723 | |
Not Available |
Full Name | Whitney M Custer |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | Bella Vista 631 Hazel St, Oshkosh, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861936270 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 13008-24 (Wisconsin) | Primary |
Provider Name | Oasis Therapy Services Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1386381598 PECOS PAC ID: 8325427974 Enrollment ID: O20220706002370 |
Mailing Address | Practice Location Address |
---|---|
Whitney M Custer, PT 1990 Green Tree Dr, Plover, WI 54467-2304 Ph: (262) 389-5723 | Whitney M Custer, PT Bella Vista 631 Hazel St, Oshkosh, WI 54901-4600 Ph: (262) 389-5723 |
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