Provider Demographics
NPI:1952438897
Name:MARTI, CINDY L (PT)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:MARTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:L
Other - Last Name:BRUECHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3333 N MAYFAIR RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53222-3219
Mailing Address - Country:US
Mailing Address - Phone:414-302-0770
Mailing Address - Fax:
Practice Address - Street 1:3333 N MAYFAIR RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53222-3219
Practice Address - Country:US
Practice Address - Phone:414-302-0770
Practice Address - Fax:414-302-0775
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3255208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP87047Medicare UPIN
WI81025-0001Medicare ID - Type Unspecified