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Individual

LINDA K NIEMELA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
5219 88TH AVE, KENOSHA, WI 53144-7468
(262) 653-0850
Mailing address
14460 W HONEY LN, NEW BERLIN, WI 53151-2314
(262) 796-9876

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5809-024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40295600
WI
Enumeration date
01/05/2007
Last updated
07/09/2007
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