Individual
COREY B WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
10725 N EXECUTIVE CT, MEQUON, WI 53092-4602
(262) 388-6262
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(262) 329-4555
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9670
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40360000
—
WI
Enumeration date
07/05/2006
Last updated
12/29/2021
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