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NPI Code Detail

MEDICARE: KELLIE HIERL

MEDICARE: KELLIE HIERL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist17748-24WI

General Provider Information

NPI Number : 1063344547
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE HIERL
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5333 N PORT WASHINGTON RD STE B
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4914
Country : US
Telephone Number : 414-716-1770
Fax Number : 414-716-1772
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ KELLIE HIERL ” Practice Location

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