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General NPI Number Information
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NPI Number | 1033009493
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Entity Type | Individual
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Provider Name | GREGORY WUNROW
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Gender | Male
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | N112W15415 MEQUON RD
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City | GERMANTOWN
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State | WI
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Zip | 53022-3410
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Country | US
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Telephone | 262-250-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 205 W SAINT PAUL AVE APT 105
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City | WAUKESHA
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State | WI
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Zip | 53188-5163
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 404719
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License Number State | WI
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