Individual
KENZIE L FEDDERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6906
Mailing address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6906
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13179-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699188516
—
WI
Enumeration date
06/09/2014
Last updated
12/18/2020
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