NPI 1396010468

Catie Fern Pontel, PTA

Practitioner Health Maintenance Organization Walworth, WI

Practice location

Address: 270 Ridge Rd, Walworth, WI 53184-9526
Phone: (262) 275-2317
Mailing address: W4929 Paddock Dr, Elkhorn, WI 53121-3106

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 1652-019 (WI)

Other Health Maintenance Organization providers in Wisconsin →

Registry record

NPI: 1396010468
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Mar 2012
Record last updated: 27 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.