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NPI Code Detail

MEDICARE: KRIS SELL PT

MEDICARE: KRIS SELL 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 Therapist3309-024WI

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 : 1962537878
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRIS SELL PT
Provider Business Mailing Address
First Line : 3301 W FOREST HOME AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-2843
Country : US
Telephone Number : 414-246-6800
Fax Number : 414-246-6405
Provider Business Practice Location Address
First Line : 9000 W SURA LN
Second Line :
City : GREENFIELD
State : WI
Zip : 53228-3477
Country : US
Telephone Number : 414-246-6800
Fax Number : 414-246-6405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 12/08/2021

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