| NPI | 1902836737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A. GILLIS Clinic Administrator 414-762-9992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 4429-024) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 1298-019) |
| 225X00000X Occupational Therapist (Licence: WI 3375-026) | |
| 2278P1005X Respiratory Therapist, Certified, Pulmonary Rehabilitation (Licence: WI 867-028) | |
| 2278P1005X Respiratory Therapist, Certified, Pulmonary Rehabilitation (Licence: WI 133-028) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |