Provider Demographics
NPI:1396896544
Name:DEUTSCH, CALVIN PETER (DPT)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:PETER
Last Name:DEUTSCH
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 1:1177 QUAIL CT STE 200
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-3768
Mailing Address - Country:US
Mailing Address - Phone:262-695-3057
Mailing Address - Fax:
Practice Address - Street 1:731 N JACKSON ST STE 800
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4612
Practice Address - Country:US
Practice Address - Phone:414-224-8219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10106024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI859400065OtherMEDICARE