Provider Demographics
NPI:1760041438
Name:OOMMEN, BELINDA (DPT)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:OOMMEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E LAYTON AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:ST FRANCIS
Mailing Address - State:WI
Mailing Address - Zip Code:53235-6054
Mailing Address - Country:US
Mailing Address - Phone:414-474-8400
Mailing Address - Fax:414-747-8414
Practice Address - Street 1:2000 E LAYTON AVE STE 160
Practice Address - Street 2:
Practice Address - City:ST FRANCIS
Practice Address - State:WI
Practice Address - Zip Code:53235-6054
Practice Address - Country:US
Practice Address - Phone:414-474-8400
Practice Address - Fax:414-747-8414
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14233-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist