Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jun 3, 2021
License(s)
15473 (WI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 725 AMERICAN AVE | Waukesha, WI 53188-5031 | 262-928-1000 |
| MAILING | 655 TURNBURRY LN | Antioch, IL 60002-1174 |
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