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General NPI Number Information
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NPI Number | 1497709364
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Entity Type | Individual
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Provider Name | CHRIS BLOCK PT
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 2301 N LAKE DR
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City | MILWAUKEE
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State | WI
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Zip | 53211-4508
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Country | US
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Telephone | 414-298-6859
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Fax |
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Provider Business Mailing Address
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Address Line | 5948 N SANTA MONICA BLVD
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City | WHITEFISH BAY
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State | WI
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Zip | 53217-4618
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Country | US
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Telephone | 414-931-1638
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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 | 5754-024
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License Number State | WI
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