Individual
MICHELLE MAXFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1388 SONATA CT, GREEN BAY, WI 54311-7397
(920) 569-6762
Mailing address
1388 SONATA CT, GREEN BAY, WI 54311-7397
(920) 569-6762
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6306-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40343400
—
WI
Enumeration date
03/22/2007
Last updated
09/24/2014
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