Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 11121 | WI |
N | 2251H1200X | Hand | PT007664 | OH |
NPI | 1023032299 |
---|---|
Provider Name | Meng-Chun Wang |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Milwaukee, WI 53215-3678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100060512 | (05) | WI |