Individual
ADELLA S DEACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1626 W FOND DU LAC AVE # WI, MILWAUKEE, WI 53205-1228
(414) 737-0374
Mailing address
1626 W FOND DU LAC AVE # WI, MILWAUKEE, WI 53205-1228
(414) 737-0374
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070014653
IL
Other
Enumeration date
09/26/2006
Last updated
05/08/2020
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