Provider Demographics
NPI:1770717217
Name:PAPE, KATHLEEN JOYCE (PHYSCIAL THERAPIST)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:JOYCE
Last Name:PAPE
Suffix:
Gender:F
Credentials:PHYSCIAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 S 108TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-4020
Mailing Address - Country:US
Mailing Address - Phone:414-475-9999
Mailing Address - Fax:414-727-5779
Practice Address - Street 1:1551 S 108TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-4020
Practice Address - Country:US
Practice Address - Phone:414-475-9999
Practice Address - Fax:414-727-5779
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2617-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist