Provider Demographics
NPI:1245895820
Name:CALL, AIMEE MICHELLE (PTA)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:MICHELLE
Last Name:CALL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:MICHELLE
Other - Last Name:MONKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19395 W CAPITOL DR # DR200
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-2736
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19395 W CAPITOL DR STE 200
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2736
Practice Address - Country:US
Practice Address - Phone:262-923-7101
Practice Address - Fax:262-923-7178
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2633-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant