Individual
GAIL E GRAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10101 W WISCONSIN AVE, WAUWATOSA, WI 53226-4861
(414) 258-1814
Mailing address
13655 W FOREST KNOLL DR, NEW BERLIN, WI 53151-2521
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
276-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40413800
—
WI
Enumeration date
05/06/2008
Last updated
05/06/2008
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