Provider Demographics
NPI:1215149307
Name:PLECHATY, KRISTINE KAY (PT)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:KAY
Last Name:PLECHATY
Suffix:
Gender:F
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:W237N6538 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3129
Mailing Address - Country:US
Mailing Address - Phone:262-820-1782
Mailing Address - Fax:
Practice Address - Street 1:N84W17049 MENOMONEE AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2701
Practice Address - Country:US
Practice Address - Phone:262-255-1180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6469-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40474600Medicaid