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General NPI Number Information
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NPI Number | 1811337132
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Entity Type | Individual
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Provider Name | TERESA O GEISBERGER P.T
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Gender | Female
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 07/01/2013
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Provider Practice Location Address
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Address Line | 1000 N 92ND ST
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City | WAUWATOSA
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State | WI
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Zip | 53226-3533
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Country | US
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Telephone | 414-479-9460
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Fax | 414-259-0575
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Provider Business Mailing Address
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Address Line | 3235 SUNNY VIEW LN
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City | BROOKFIELD
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State | WI
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Zip | 53005-2970
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Country | US
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Telephone | 414-403-4509
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 2723-24
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License Number State | WI
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