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NPI Code Detail

MEDICARE: MICHELLE M KREITER PT

MEDICARE: MICHELLE M KREITER PT
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 Therapist4328-024WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154457604
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE M KREITER PT
Provider Business Mailing Address
First Line : W314S8909 WIGWAM DR
Second Line :
City : MUKWONAGO
State : WI
Zip : 53149-8887
Country : US
Telephone Number : 262-363-0823
Fax Number :
Provider Business Practice Location Address
First Line : 4214 SHERIDAN RD
Second Line :
City : RACINE
State : WI
Zip : 53403-4142
Country : US
Telephone Number : 262-554-5006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 07/08/2007

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