Provider Demographics
NPI:1225879950
Name:RAHMLOW, EMMA LEE ROSE (PTA)
Entity type:Individual
Prefix:
First Name:EMMA LEE
Middle Name:ROSE
Last Name:RAHMLOW
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 1:960 S RAPIDS RD
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4146
Mailing Address - Country:US
Mailing Address - Phone:920-684-1144
Mailing Address - Fax:
Practice Address - Street 1:960 S RAPIDS RD
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-4146
Practice Address - Country:US
Practice Address - Phone:920-684-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
WI417219225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant