Healthcare Provider Details
I. General information
NPI: 1518758648
Provider Name (Legal Business Name): ARIONNA OBRIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/16/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
813 N MAYFAIR RD
WAUWATOSA WI
53226-4241
US
IV. Provider business mailing address
33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US
V. Phone/Fax
- Phone: 414-522-9000
- Fax: 414-522-9007
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 17158-24 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: