Provider Demographics
NPI:1801225743
Name:JANZOW, CATHERINE (DPT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:JANZOW
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 1:1510 GABRIEL DR
Mailing Address - Street 2:#3
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3658
Mailing Address - Country:US
Mailing Address - Phone:815-953-9307
Mailing Address - Fax:
Practice Address - Street 1:1510 GABRIEL DR
Practice Address - Street 2:#3
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3658
Practice Address - Country:US
Practice Address - Phone:815-953-9307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11593-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist