Mr. Mark Allen Medina
Physical Therapy Assistant
3471 S Kansas Ave
Milwaukee
, Wisconsin 53207-3654
Mr. Mark Allen Medina
Physical Therapy Assistant
3471 S Kansas Ave
Milwaukee
, Wisconsin 53207-3654
(414) 486-1307
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About
Features
Specialties
- Physical Therapy Assistant
Languages spoken
- English
Location
First Address
- Mr. Mark Allen Medina
- 3471 S Kansas Ave
- Milwaukee, WI
- Zip : 53207-3654
- Phone : (414) 486-1307
Second Address
- Mr. Mark Allen Medina
- 3471 S Kansas Ave
- Milwaukee, WI
- Zip : 53207-3654
- Phone : (414) 486-1307
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225200000X | Physical Therapy Assistant | 0848-19 | WI |
National Provider Identifier
| NPI | 1023052099 |
|---|---|
| Provider Name | Mr. Mark Allen Medina |
| First Address | Milwaukee, WI 53207-3654 |
| Second Address | Milwaukee, WI 53207-3654 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/06/2006 |
| Last Update Date | 06/11/2013 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.