Individual
MRS. KRISTINE STASZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6408 COPPS AVE, MONONA, WI 53716-3702
(608) 417-3131
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4909-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487713780
—
WI
Enumeration date
12/06/2006
Last updated
12/19/2011
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