Provider Demographics
NPI:1306684220
Name:PIETZ, ELISABET ASPLUND (DPT)
Entity type:Individual
Prefix:DR
First Name:ELISABET
Middle Name:ASPLUND
Last Name:PIETZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 N PHOENIX RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9488
Mailing Address - Country:US
Mailing Address - Phone:541-630-3055
Mailing Address - Fax:541-244-3020
Practice Address - Street 1:709 N PHOENIX RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9488
Practice Address - Country:US
Practice Address - Phone:541-630-3055
Practice Address - Fax:541-244-3020
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16763-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist