Provider Demographics
NPI:1801101738
Name:HANKE, ADAM (PT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HANKE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10233 W GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3911
Mailing Address - Country:US
Mailing Address - Phone:414-856-1888
Mailing Address - Fax:
Practice Address - Street 1:3045 N MLK DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-2076
Practice Address - Country:US
Practice Address - Phone:414-856-1888
Practice Address - Fax:414-727-5779
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11526225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist