Provider Demographics
NPI:1013541010
Name:TOEPEL, MARILYNN
Entity Type:Individual
Prefix:
First Name:MARILYNN
Middle Name:
Last Name:TOEPEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W133N6242 HUMMINGBIRD WAY
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-8330
Mailing Address - Country:US
Mailing Address - Phone:414-322-3997
Mailing Address - Fax:
Practice Address - Street 1:S11W29667 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-9476
Practice Address - Country:US
Practice Address - Phone:262-565-6124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6007-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist