Provider Demographics
NPI:1740302959
Name:TREDO, KATIE M (PT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:M
Last Name:TREDO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6028 W MEQUON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-1938
Mailing Address - Country:US
Mailing Address - Phone:262-236-0176
Mailing Address - Fax:262-236-0178
Practice Address - Street 1:6028 W MEQUON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-1938
Practice Address - Country:US
Practice Address - Phone:262-236-0176
Practice Address - Fax:262-236-0178
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2015-11-11
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Provider Licenses
StateLicense IDTaxonomies
WI13170-24208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation