Individual
KAYE ANNE TRADEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6101 16TH ST, RACINE, WI 53406-4467
(262) 898-2777
(262) 619-1547
Mailing address
6101 16TH ST, RACINE, WI 53406-4467
(262) 898-2777
(262) 619-1547
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
982-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104042472
—
WI
Enumeration date
04/17/2007
Last updated
01/12/2014
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