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General NPI Number Information
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NPI Number | 1821761024
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Entity Type | Individual
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Provider Name | KAY CAROLYN CHMIELEWSKI DPT
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Gender | Female
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 6220 S 108TH ST STE D
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City | HALES CORNERS
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State | WI
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Zip | 53130-2527
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Country | US
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Telephone | 414-533-7949
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Fax |
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Provider Business Mailing Address
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Address Line | 12101 W WHITE OAK DR
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City | GREENFIELD
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State | WI
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Zip | 53228-1049
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Country | US
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Telephone | 414-758-8922
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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 | 11009-24
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License Number State | WI
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