Provider Demographics
NPI:1306273602
Name:ELLERMAN, ARNEETRICE (COMS)
Entity type:Individual
Prefix:
First Name:ARNEETRICE
Middle Name:
Last Name:ELLERMAN
Suffix:
Gender:F
Credentials:COMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:WI
Mailing Address - Zip Code:53171-0075
Mailing Address - Country:US
Mailing Address - Phone:262-859-0100
Mailing Address - Fax:262-859-0200
Practice Address - Street 1:10226 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-7448
Practice Address - Country:US
Practice Address - Phone:262-859-0100
Practice Address - Fax:262-859-0200
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind