Provider Demographics
NPI:1396020194
Name:MARQUETTE UNIVERSITY
Entity Type:Organization
Organization Name:MARQUETTE UNIVERSITY
Other - Org Name:MARQUETTE PHYSICAL THERAPY CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:DEAN OF COLLEGE OF HEALTH SCIENCES
Authorized Official - Prefix:MS
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLINAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-288-1400
Mailing Address - Street 1:604 N 16TH ST RM 215
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-2117
Mailing Address - Country:US
Mailing Address - Phone:414-288-1400
Mailing Address - Fax:414-288-6079
Practice Address - Street 1:604 N 16TH ST RM 215
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-2117
Practice Address - Country:US
Practice Address - Phone:414-288-1400
Practice Address - Fax:414-293-5509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty