Provider Demographics
NPI:1710319751
Name:SAUGEN, EMILY ANN (DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:SAUGEN
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 1:10412 N BAEHR RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-4472
Mailing Address - Country:US
Mailing Address - Phone:262-236-0176
Mailing Address - Fax:
Practice Address - Street 1:10412 N BAEHR RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-4472
Practice Address - Country:US
Practice Address - Phone:262-236-0176
Practice Address - Fax:262-236-0178
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2162877225100000X
WI13734-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100067039Medicaid