MEDICARE: KATHLEEN JOYCE PAPE PHYSCIAL THERAPIST

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	2617-024	WI

General Provider Information

NPI Number	:	1770717217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN JOYCE PAPE PHYSCIAL THERAPIST

Provider Business Mailing Address
First Line	:	1551 S 108TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-4020
Country	:	US
Telephone Number	:	414-475-9999
Fax Number	:	414-727-5779

Provider Business Practice Location Address
First Line	:	1551 S 108TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-4020
Country	:	US
Telephone Number	:	414-475-9999
Fax Number	:	414-727-5779

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

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	05/03/2012

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