Healthcare Provider Details

I. General information

NPI: 1063845857
Provider Name (Legal Business Name): ADAM D FRANZEN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 E OGDEN AVE SUITE 9
MILWAUKEE WI
53202-2698
US

IV. Provider business mailing address

3048 MOMENTUM PL
CHICAGO IL
60689-5330
US

V. Phone/Fax

Practice location:
  • Phone: 414-224-7834
  • Fax: 414-224-7835
Mailing address:
  • Phone: 262-657-0222
  • Fax: 262-657-7190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12463-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: