Provider Demographics
NPI:1245016880
Name:PLUME, PARKER JAMES (PT, DPT)
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:JAMES
Last Name:PLUME
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 S ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-3032
Mailing Address - Country:US
Mailing Address - Phone:414-416-6021
Mailing Address - Fax:
Practice Address - Street 1:3245 S ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-3032
Practice Address - Country:US
Practice Address - Phone:414-416-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1649624225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist