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General NPI Number Information
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NPI Number | 1548486467
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Entity Type | Individual
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Provider Name | CYNTHIA DENISE IRELAND PT ASST
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3939 S 92 ST
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City | GREENFIELD
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State | WI
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Zip | 53228
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Country | US
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Telephone | 414-546-7340
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Fax |
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Provider Business Mailing Address
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Address Line | 3043 N 76 ST #2
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City | MILWAUKEE
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State | WI
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Zip | 53222-5048
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Country | US
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Telephone | 414-546-7340
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 746019
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License Number State | WI
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