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Individual

MICHELLE C PAULOWSKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
8400 LAKEVIEW PARKWAY, PLEASANT PRAIRIE, WI 53158
(262) 697-7295
(262) 697-9412
Mailing address
3601 30TH AVE, STE 103, KENOSHA, WI 53144
(262) 657-0222
(626) 657-7190

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3855026
WI
225100000X
Physical Therapist
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40890000
WI
Enumeration date
06/22/2006
Last updated
07/08/2007
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