Provider Demographics
NPI:1104091552
Name:MCAULIFFE, HILLARY JUNE (PTA)
Entity type:Individual
Prefix:MRS
First Name:HILLARY
Middle Name:JUNE
Last Name:MCAULIFFE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53818-1452
Mailing Address - Country:US
Mailing Address - Phone:608-348-2453
Mailing Address - Fax:608-348-2944
Practice Address - Street 1:1300 N WATER ST
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-1452
Practice Address - Country:US
Practice Address - Phone:608-348-2453
Practice Address - Fax:608-348-2944
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI843019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40328100Medicaid