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General NPI Number Information
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NPI Number | 1104469261
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Entity Type | Organization
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Legal Business Name | CROSSPHYSIO
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 2627 S GREELEY ST STE 100
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City | MILWAUKEE
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State | WI
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Zip | 53207-2027
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Country | US
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Telephone | 414-768-2504
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Fax |
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Provider Business Mailing Address
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Address Line | 10270 W SCEPTER CT
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City | FRANKLIN
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State | WI
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Zip | 53132-1853
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Country | US
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Telephone | 630-981-7415
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. GUILLERMO CONTRERAS
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Credential | PT, DPT
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Telephone | 630-981-7415
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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 |
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License Number State |
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