Individual
COLE J LEWANDOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3620 57TH AVE STE 400, KENOSHA, WI 53144-4925
(262) 925-5250
Mailing address
600 52ND ST STE 240, KENOSHA, WI 53140-3423
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14676-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14676-24
STATE OF WISCONSIN
WI
Enumeration date
06/13/2019
Last updated
06/13/2019
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