Provider Demographics
NPI:1003834755
Name:MAJSZAK, ELIZABETH A (PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:MAJSZAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:KISSNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2520 S BRISBANE AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-1502
Mailing Address - Country:US
Mailing Address - Phone:414-433-4943
Mailing Address - Fax:
Practice Address - Street 1:4131 W LOOMIS RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-2051
Practice Address - Country:US
Practice Address - Phone:414-281-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist