Provider Demographics
NPI:1770092348
Name:KITTEN, JOSEPH (DPT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KITTEN
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 1:600 52ND ST STE 240
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-3423
Mailing Address - Country:US
Mailing Address - Phone:1262-925-5004
Mailing Address - Fax:262-925-5001
Practice Address - Street 1:9809 39TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-3733
Practice Address - Country:US
Practice Address - Phone:262-925-5080
Practice Address - Fax:262-925-5081
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13951-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI14108788OtherCAQH