Individual
MARY ALICE HANNEKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1516 W. MEQUON RD, STE 201, MEQUON, WI 53012-3264
(262) 241-8402
(262) 241-8403
Mailing address
1516 W. MEQUON RD, STE 201, MEQUON, WI 53012-3264
(262) 241-8402
(262) 241-8403
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2857-024
WI
Other
Enumeration date
08/26/2012
Last updated
12/17/2014
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