Provider Demographics
NPI:1063718476
Name:WHYOGA INC
Entity type:Organization
Organization Name:WHYOGA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JURKEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:262-467-6102
Mailing Address - Street 1:2040 ERIN CT
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4815
Mailing Address - Country:US
Mailing Address - Phone:414-467-6102
Mailing Address - Fax:262-786-6102
Practice Address - Street 1:700 PILGRIM PKWY
Practice Address - Street 2:SUITE L9
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2063
Practice Address - Country:US
Practice Address - Phone:414-467-6102
Practice Address - Fax:262-786-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1740-024261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy