Individual
MR. KEVIN JOSEPH ZACHARIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1100 E VERONA AVE, VERONA, WI 53593-8717
(608) 845-1262
Mailing address
2056 BONNIE LN, STOUGHTON, WI 53589-3303
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
725-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40336900
—
WI
Enumeration date
12/01/2006
Last updated
07/09/2007
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