Individual
KYLE RAY FISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2448 S 102ND ST, MILWAUKEE, WI 53227-2466
(414) 329-2500
Mailing address
805 ABBEY LN, VIROQUA, WI 54665-1075
(608) 632-5626
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2982-19
WI
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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