Provider Demographics
NPI:1316659956
Name:RESHESKE, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:RESHESKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 FRANKLIN ST W
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:WI
Mailing Address - Zip Code:54669-1529
Mailing Address - Country:US
Mailing Address - Phone:608-386-8265
Mailing Address - Fax:
Practice Address - Street 1:535 FRANKLIN ST W
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:WI
Practice Address - Zip Code:54669-1529
Practice Address - Country:US
Practice Address - Phone:608-386-8265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3324-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant