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NPI 1689169997

NPI 1689169997 : LUKE MENGES PT : GREENFIELD, WI

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General NPI Number Information
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    NPI Number           |    1689169997
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    Entity Type          |    Individual 
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    Provider Name        |    LUKE MENGES PT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/28/2018
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    Last Update Date     |    05/27/2025
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Provider Practice Location Address
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    Address Line         |    9000 W SURA LN 
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    City                 |    GREENFIELD
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    State                |    WI
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    Zip                  |    53228-3477
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    Country              |    US
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    Telephone            |    414-246-6800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 735044 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60673-5044
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    Country              |    US
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    Telephone            |    800-332-6225
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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        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    14268-24
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    License Number State |    WI
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    14268-24
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    License Number State |    WI
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