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General NPI Number Information
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NPI Number | 1750530812
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Entity Type | Organization
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Legal Business Name | A STEP AHEAD PHYSICAL THERAPY SERVICES
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 2915 S KINNICKINNIC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53207-2518
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Country | US
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Telephone | 414-712-4515
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Fax | 414-751-5145
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Provider Business Mailing Address
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Address Line | 2915 S KINNICKINNIC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53207-2518
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Country | US
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Telephone | 414-712-4515
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Fax | 414-751-5145
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARGARET GONZALES-CHARLES
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Credential | PT
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Telephone | 414-712-4515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 3591-24
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License Number State | WI
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