Individual
RENATA B PTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2501 W SILVER SPRING DR, GLENDALE, WI 53209-4217
(414) 461-9250
(414) 461-3553
Mailing address
2501 W SILVER SPRING DR, GLENDALE, WI 53209-4217
(414) 461-9250
(414) 461-3553
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1779-023
WI
Other
Enumeration date
01/09/2007
Last updated
06/30/2020
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