Individual
CHRISTINE RADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
10222 74TH ST STE 211, KENOSHA, WI 53142-6810
(262) 925-5020
(262) 925-5021
Mailing address
600 52ND ST STE 240, KENOSHA, WI 53140-3423
(262) 925-5004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11999-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14133373
CAQH
WI
Enumeration date
04/25/2013
Last updated
11/13/2017
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