Provider Demographics
NPI:1114235033
Name:JURINEK, ABIGAIL FAYE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:FAYE
Last Name:JURINEK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 W LAYTON AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4500
Mailing Address - Country:US
Mailing Address - Phone:414-282-9590
Mailing Address - Fax:414-282-9348
Practice Address - Street 1:6520 W LAYTON AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4500
Practice Address - Country:US
Practice Address - Phone:414-282-9590
Practice Address - Fax:414-282-9348
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11599-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist