Provider Demographics
NPI:1558663682
Name:GESKE, ADAM CHRISTOPHER (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:GESKE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 SHORE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-4294
Mailing Address - Country:US
Mailing Address - Phone:715-732-5211
Mailing Address - Fax:715-732-0628
Practice Address - Street 1:3117 SHORE DR STE 101
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-4294
Practice Address - Country:US
Practice Address - Phone:715-732-5211
Practice Address - Fax:715-732-0628
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11489-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist