Individual
CARMELO D TENUTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
10222 74TH ST, SUITE 211, KENOSHA, WI 53142-6810
(262) 925-5020
(262) 925-5021
Mailing address
3921 30TH AVE STE C, KENOSHA, WI 53144-1957
(262) 925-5004
(262) 925-5001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3494024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11231652
CAQH
—
05
—
40178100
—
WI
Enumeration date
06/02/2006
Last updated
06/05/2020
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