Individual
KELLY DORFNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1125 E FITZSIMMONS RD, OAK CREEK, WI 53154-5231
(414) 213-4263
Mailing address
1125 E FITZSIMMONS RD, OAK CREEK, WI 53154-5231
(414) 213-4263
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1302
WI
225700000X
Massage Therapist
4547
WI
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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