Provider Demographics
NPI:1295334878
Name:SANABRAIS, MARQUIS LUIS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MARQUIS
Middle Name:LUIS
Last Name:SANABRAIS
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 1:5781 VERDE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-5869
Mailing Address - Country:US
Mailing Address - Phone:847-977-6195
Mailing Address - Fax:
Practice Address - Street 1:1619 N STOUGHTON RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2603
Practice Address - Country:US
Practice Address - Phone:262-442-4273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15263-24208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation