Individual
GINESA S TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4749 S 76TH ST STE 201, GREENFIELD, WI 53220-4301
(414) 281-1380
(414) 281-1381
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
(630) 928-5080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9642
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40367100
—
WI
Enumeration date
07/09/2006
Last updated
11/24/2020
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