Individual
JOSEPH KUCKSDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3263 EATON RD, GREEN BAY, WI 54311-6830
(920) 433-6700
(920) 430-4745
Mailing address
3263 EATON RD, GREEN BAY, WI 54311-6830
(920) 433-6700
(920) 430-4745
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11460-24
WI
Other
Enumeration date
06/03/2010
Last updated
06/03/2010
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