Provider Demographics
NPI:1093974701
Name:PALY, ELIZABETH L (PT DPT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:L
Last Name:PALY
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W BROWN DEER RD
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2400
Mailing Address - Country:US
Mailing Address - Phone:414-357-7072
Mailing Address - Fax:414-355-2767
Practice Address - Street 1:4301 W BROWN DEER RD
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-2400
Practice Address - Country:US
Practice Address - Phone:414-357-7072
Practice Address - Fax:414-355-2767
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2532 024225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI390816857OtherTAX IDENTIFICATION