Provider Demographics
NPI:1548856891
Name:FIER, MARIAH JEANNE (DPT)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:JEANNE
Last Name:FIER
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 1:490 COUNTRY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-7814
Mailing Address - Country:US
Mailing Address - Phone:715-781-0364
Mailing Address - Fax:
Practice Address - Street 1:1600 MAXWELL DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8758
Practice Address - Country:US
Practice Address - Phone:844-328-5866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist