Provider Demographics
NPI:1326245036
Name:PEPLINSKI, SUE (PT)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:PEPLINSKI
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:W1226 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:WI
Mailing Address - Zip Code:53156-9797
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 S CURTIS ST
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-2052
Practice Address - Country:US
Practice Address - Phone:262-248-2680
Practice Address - Fax:262-248-2746
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4375-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40245000Medicaid