Provider Demographics
NPI:1710674593
Name:STANISIC, MARGARET MCCARTY (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MCCARTY
Last Name:STANISIC
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 1:640 W FRESHWATER WAY APT 303
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-4128
Mailing Address - Country:US
Mailing Address - Phone:262-391-9503
Mailing Address - Fax:414-805-8514
Practice Address - Street 1:8900 W DOYNE AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-1265
Practice Address - Country:US
Practice Address - Phone:414-805-5452
Practice Address - Fax:414-805-8514
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6463-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist