Healthcare Provider Details

I. General information

NPI: 1396020194
Provider Name (Legal Business Name): MARQUETTE UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 N 16TH ST RM 215
MILWAUKEE WI
53233-2117
US

IV. Provider business mailing address

604 N 16TH ST RM 215
MILWAUKEE WI
53233-2117
US

V. Phone/Fax

Practice location:
  • Phone: 414-288-1400
  • Fax: 414-293-5509
Mailing address:
  • Phone: 414-288-1400
  • Fax: 414-288-6079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. WILLIAM CULLINAN
Title or Position: DEAN OF COLLEGE OF HEALTH SCIENCES
Credential:
Phone: 414-288-1400