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Contact Information

CHRISTIE I GUSTAFSON, LPTA
706 BRATLEY DRIVE
WASHBURN, WI54891
 Phone: 715-373-6425
 Fax: 715-373-5655
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for CHRISTIE I GUSTAFSON · (Female)

NPI Number 1932436789
Status Active
Credentials LPTA
Entity Individual
Enumeration date 11/13/2009
Last updated 09/10/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 565-019
  • WI Medicaid 20194600
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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