Individual
RICHARD PITTSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8633 32ND AVE, KENOSHA, WI 53142-5187
(262) 694-8800
Mailing address
8633 32ND AVE, KENOSHA, WI 53142-5187
(262) 694-8800
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1446-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36177900
—
WI
Enumeration date
10/06/2008
Last updated
10/06/2008
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