Provider Demographics
NPI:1932470705
Name:MILAZZO, JOSEPH PHILLIP (DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PHILLIP
Last Name:MILAZZO
Suffix:
Gender:M
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:W264N2044 DEER HAVEN CT # B
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-6623
Mailing Address - Country:US
Mailing Address - Phone:414-510-3272
Mailing Address - Fax:
Practice Address - Street 1:6109 BRAUN RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53403-9409
Practice Address - Country:US
Practice Address - Phone:262-977-6726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1125224225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist