Provider Demographics
NPI:1205112018
Name:SCHELL, ANNETTE MICHELLE (DPT)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MICHELLE
Last Name:SCHELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:MICHELLE
Other - Last Name:PECORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3821 S CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-3712
Mailing Address - Country:US
Mailing Address - Phone:414-762-7336
Mailing Address - Fax:414-762-5077
Practice Address - Street 1:3821 S CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53172-3712
Practice Address - Country:US
Practice Address - Phone:414-762-7336
Practice Address - Fax:414-762-5077
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11770-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist