Provider Demographics
NPI:1699938043
Name:BROTHERTON, JANA L (PT)
Entity type:Individual
Prefix:MRS
First Name:JANA
Middle Name:L
Last Name:BROTHERTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:LINN
Other - Last Name:MCNULTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1905 E. HUEBBE PARKWAY
Mailing Address - Street 2:BELOIT HEALTH SYSTEM INC.
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-1842
Mailing Address - Country:US
Mailing Address - Phone:608-364-2200
Mailing Address - Fax:608-363-7395
Practice Address - Street 1:1650 LEE LN.
Practice Address - Street 2:OCUPATIONAL HEALTH SPORTS & FAMILY MEDICINE CENTER
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-3935
Practice Address - Country:US
Practice Address - Phone:608-362-0211
Practice Address - Fax:608-364-4670
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11815997225100000X
WI12237-24225100000X
IL070-019663225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist