Individual
KIMBERLY NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3205 WOOD RD, RACINE, WI 53406-5048
(262) 598-9146
Mailing address
3205 WOOD RD, RACINE, WI 53406-5048
(262) 598-9146
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10120-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40396600
—
WI
Enumeration date
04/09/2008
Last updated
04/09/2008
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