Individual
MELINDA KATHRYN MAZUREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5374 BALBOA DR, NEW BERLIN, WI 53151-8112
(414) 529-9780
Mailing address
5374 BALBOA DR, NEW BERLIN, WI 53151-8112
(414) 529-9780
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2676024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40141400
—
WI
Enumeration date
05/22/2007
Last updated
07/09/2007
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