MEDICARE: JYRON APARRI DPT

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
1	225100000X	Physical Therapist	13980-24	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14078422	OTHER	WI	CAQH

General Provider Information

NPI Number	:	1326563990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JYRON APARRI DPT

Provider Business Mailing Address
First Line	:	600 52ND ST STE 240
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53140-3423
Country	:	US
Telephone Number	:	12629255004
Fax Number	:	262-925-5001

Provider Business Practice Location Address
First Line	:	7200 WASHINGTON AVE STE 103
Second Line	:
City	:	MOUNT PLEASANT
State	:	WI
Zip	:	53406-6516
Country	:	US
Telephone Number	:	262-583-0790
Fax Number	:	262-583-0768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2017
Last Update Date	:	08/04/2017

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Directions to “ JYRON APARRI DPT” Practice Location

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