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NPI Code Detail

MEDICARE: ABIGAIL LEY MPT

MEDICARE: ABIGAIL LEY MPT
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 Therapist070-016315IL
2225100000XPhysical Therapist11205-24WI

General Provider Information

NPI Number : 1356513436
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL LEY MPT
Provider Business Mailing Address
First Line : 2615 N DOWNER AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-4245
Country : US
Telephone Number : 414-962-4400
Fax Number : 414-962-5674
Provider Business Practice Location Address
First Line : 2615 N DOWNER AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-4245
Country : US
Telephone Number : 414-962-4400
Fax Number : 414-962-5674
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2008
Last Update Date : 03/14/2011

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Directions to “ ABIGAIL LEY MPT” Practice Location

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