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General NPI Number Information
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NPI Number | 1477900561
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Entity Type | Organization
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Legal Business Name | THERAPY AT HOME LLC
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 7711 FREELAND CT
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City | GREENDALE
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State | WI
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Zip | 53129
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Country | US
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Telephone | 414-210-0088
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Fax |
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Provider Business Mailing Address
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Address Line | 7711 FREELAND CT
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City | GREENDALE
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State | WI
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Zip | 53129-1658
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Country | US
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Telephone | 414-210-0088
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. MUDDASSIR MOHIUDDIN
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Credential |
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Telephone | 414-210-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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