Individual
GREGORY L RASMUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, ATC
Contact information
Practice address
N112W17975 MEQUON RD, GERMANTOWN, WI 53022-2425
(262) 532-7600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12027
MN
225100000X
Physical Therapist
Primary
15621-24
WI
2255A2300X
Athletic Trainer
1657
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100181572
—
WI
Enumeration date
06/17/2015
Last updated
09/24/2024
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