Provider Demographics
NPI:1760028229
Name:ZILLER, RICHARD (MOTR/L)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ZILLER
Suffix:
Gender:M
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W175N11163 STONEWOOD DR STE 232
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-6503
Mailing Address - Country:US
Mailing Address - Phone:262-375-2020
Mailing Address - Fax:
Practice Address - Street 1:W175N11163 STONEWOOD DR STE 232
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-6503
Practice Address - Country:US
Practice Address - Phone:262-375-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification