Provider Demographics
NPI:1568037315
Name:MROZ, ANNA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:MROZ
Suffix:
Gender:F
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 1:7907 S 67TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9299
Mailing Address - Country:US
Mailing Address - Phone:847-345-2375
Mailing Address - Fax:
Practice Address - Street 1:24726 75TH ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:WI
Practice Address - Zip Code:53168-9704
Practice Address - Country:US
Practice Address - Phone:262-843-8333
Practice Address - Fax:262-843-2948
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15393-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist