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General NPI Number Information
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NPI Number | 1275580656
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Entity Type | Organization
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Legal Business Name | JOHN A. ROFFERS, M.D., S.C.
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 2015 E NEWPORT AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-2984
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Country | US
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Telephone | 414-961-4161
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Fax | 414-967-1778
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Provider Business Mailing Address
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Address Line | 2015 E NEWPORT AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-2984
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Country | US
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Telephone | 414-961-4161
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Fax | 414-967-1778
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Authorized Official
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Title or Position | SECRETARY
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Name | ELIZABETH ROFFERS
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Credential |
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Telephone | 414-961-4161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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