Individual
JACK HEINRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
10930 W POTTER RD STE C, WAUWATOSA, WI 53226-3450
(414) 400-6556
(414) 400-6557
Mailing address
10930 W POTTER RD STE C, WAUWATOSA, WI 53226-3450
(414) 400-6556
(414) 400-6557
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16297-24
WI
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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