Provider Demographics
NPI:1073162632
Name:MAAS, CORIANNE B (PT)
Entity Type:Individual
Prefix:
First Name:CORIANNE
Middle Name:B
Last Name:MAAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CORIANNE
Other - Middle Name:B
Other - Last Name:STRUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:925 STATE ST APT 8
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-3882
Mailing Address - Country:US
Mailing Address - Phone:920-212-1624
Mailing Address - Fax:
Practice Address - Street 1:N82W15485 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3711
Practice Address - Country:US
Practice Address - Phone:920-212-1624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist