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NPI Code Detail

MEDICARE: MRS. CHERYL ANN ROBILLARD PT

MEDICARE: MRS. CHERYL ANN ROBILLARD 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 Therapist2827-024WI
22251G0304XGeriatric Physical Therapist2827-024WI

General Provider Information

NPI Number : 1225213390
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL ANN ROBILLARD PT
Provider Business Mailing Address
First Line : 1006 N 122ND ST
Second Line :
City : WAUWATOSA
State : WI
Zip : 53226-3312
Country : US
Telephone Number : 414-467-9983
Fax Number :
Provider Business Practice Location Address
First Line : 1616 W BENDER RD
Second Line :
City : GLENDALE
State : WI
Zip : 53209-3802
Country : US
Telephone Number : 414-228-8700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2008
Last Update Date : 08/08/2014

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