Individual
BLAKE KITTREDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
N6359 US HIGHWAY 12, ELKHORN, WI 53121-3955
(262) 723-2700
Mailing address
11178 W APPLETON AVE, MILWAUKEE, WI 53225-1213
(414) 403-2623
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17638-24
WI
225200000X
Physical Therapy Assistant
Primary
3030-19
WI
Other
Enumeration date
11/06/2023
Last updated
04/09/2026
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