Individual
CONNIE KITTLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
13111 N PORT WASHINGTON RD, MEQUON, WI 53097-2416
(262) 243-7300
Mailing address
10509 N FAIRWAY LN, MEQUON, WI 53092-5152
(262) 242-3373
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5406-024
WI
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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