Organization
PHYSIATRISTS ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDAVAR M GOPAL M.D. (PRESIDENT)
(414) 647-9985
Entity
Organization
Contact information
Practice address
3201 S 16TH ST, 800, MILWAUKEE, WI 53215-4537
(414) 647-9985
Mailing address
PO BOX 1790, BROOKFIELD, WI 53008-1790
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32738900
—
WI
Enumeration date
11/14/2006
Last updated
08/22/2020
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