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Individual

KIRBY TRELEVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-5600
Mailing address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-5600

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11285
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11285-24
WI LIC
WI
Enumeration date
07/24/2009
Last updated
04/17/2012
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