Healthcare Provider Details

I. General information

NPI: 1265336960
Provider Name (Legal Business Name): ALYSSA KATHRYN PIEK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N84W16889 MENOMONEE AVE
MENOMONEE FALLS WI
53051-2810
US

IV. Provider business mailing address

2758 N 118TH ST
WAUWATOSA WI
53222-4109
US

V. Phone/Fax

Practice location:
  • Phone: 262-250-1870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1796524
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: