Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 10499-024 | WI |
N | 2251P0200X | Physical Therapist - Pediatrics | 10499-024 | WI |
NPI | 1114966975 |
---|---|
Provider Name | Meghan Maureen Denis |
First Address | Milwaukee, WI 53202-1493 |
Second Address | Milwaukee, WI 53211-2906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 08/07/2007 |