Individual
LEAH MIKRUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2448 S 102ND ST, MILWAUKEE, WI 53227-2466
(414) 329-2500
Mailing address
3315 26TH ST S, LA CROSSE, WI 54601-7912
(262) 949-9907
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3087-19
WI
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
08/30/2020
Last updated
09/10/2020
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