| NPI | 1235222746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA D MARTIN Owner 414-571-9146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 5437) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 5672) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-03-11 |