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NPI Code Detail

MEDICARE: MRS. CRYSTAL M TOLL PT

MEDICARE:  MRS. CRYSTAL M TOLL  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist9995-024WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144275504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CRYSTAL M TOLL PT
Provider Business Mailing Address
First Line : 3301 W FOREST HOME AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-2843
Country : US
Telephone Number : 414-332-7475
Fax Number : 414-332-7494
Provider Business Practice Location Address
First Line : 4655 N PORT WASHINGTON RD STE 350
Second Line :
City : GLENDALE
State : WI
Zip : 53212-1004
Country : US
Telephone Number : 414-332-7475
Fax Number : 414-332-7494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 01/04/2022

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Directions to “ MRS. CRYSTAL M TOLL PT” Practice Location

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