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NPI Code Detail

MEDICARE: MR. KEVIN JOSEPH ZACHARIAS LPTA

MEDICARE:  MR. KEVIN JOSEPH ZACHARIAS  LPTA
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
1225200000XPhysical Therapy Assistant725-019WI

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 : 1679641559
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN JOSEPH ZACHARIAS LPTA
Provider Business Mailing Address
First Line : 2056 BONNIE LN
Second Line :
City : STOUGHTON
State : WI
Zip : 53589-3303
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1100 E VERONA AVE
Second Line :
City : VERONA
State : WI
Zip : 53593-8717
Country : US
Telephone Number : 608-845-1262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 07/09/2007

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Directions to “ MR. KEVIN JOSEPH ZACHARIAS LPTA” Practice Location

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