Provider Demographics
NPI:1245403591
Name:KROFTA, JOANN (PT)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:KROFTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W349S3935 WATERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DOUSMAN
Mailing Address - State:WI
Mailing Address - Zip Code:53118-9786
Mailing Address - Country:US
Mailing Address - Phone:262-965-4733
Mailing Address - Fax:
Practice Address - Street 1:W349S3935 WATERVILLE RD
Practice Address - Street 2:
Practice Address - City:DOUSMAN
Practice Address - State:WI
Practice Address - Zip Code:53118-9786
Practice Address - Country:US
Practice Address - Phone:262-965-4733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist