Taylor Husom

NPI #1629693676 in Port Washington, Wisconsin

Provider Information

NPI Number: 1629693676
Entity Type: Individual
Name: Taylor Husom
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: Jun 15, 2020
Last Updated: Jun 15, 2020

Practice Location

Address: 1300 W LINCOLN AVE
City: Port Washington
State: Wisconsin
ZIP Code: 53074-2098
Phone: (479) 201-6098

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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