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Individual

ALEXANDER DANIEL ZACHARIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2835 N GRANDVIEW BLVD STE 100, PEWAUKEE, WI 53072-5546
(262) 574-1100
(262) 574-5193
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100294444
WI
Enumeration date
07/10/2024
Last updated
11/20/2024
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