Individual
ADAM KUPIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 763-2411
Mailing address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1133-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36128500
—
WI
Enumeration date
06/13/2007
Last updated
07/08/2007
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