Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 4394-24 | WI |
NPI | 1013321124 |
---|---|
Provider Name | Dr. Victoria Ann Moerchen |
First Address | Milwaukee, WI 53201-0413 |
Second Address | Milwaukee, WI 53211-2956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2014 |
Last Update Date | 17/06/2014 |