Individual
MICHAEL A. LAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2664 S ONEIDA ST STE 102, GREEN BAY, WI 54304-5615
(920) 321-5700
(920) 888-4283
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9573-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000786035
MEDICARE
WI
05
—
40345700
—
WI
01
—
650024852
RAILROAD MEDICARE
WI
01
—
650025192
RAILROAD MEDICARE
WI
Enumeration date
08/22/2006
Last updated
07/21/2022
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