Individual
MATAYAH MORGAN PETHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3117 SHORE DR, MARINETTE, WI 54143-4293
(715) 732-5111
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17165-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100331448
—
WI
Enumeration date
06/13/2025
Last updated
07/17/2025
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