Provider Demographics
NPI:1558550152
Name:MARIA ZANONI PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:MARIA ZANONI PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:ZANONI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:414-331-8970
Mailing Address - Street 1:890 ELM GROVE RD
Mailing Address - Street 2:SUITE 104B
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2528
Mailing Address - Country:US
Mailing Address - Phone:262-784-2476
Mailing Address - Fax:262-784-5472
Practice Address - Street 1:890 ELM GROVE RD
Practice Address - Street 2:SUITE 104B
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2528
Practice Address - Country:US
Practice Address - Phone:262-784-2476
Practice Address - Fax:262-784-5472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2879-024261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40113500Medicaid