Provider Demographics
NPI:1962508168
Name:MEISEL, KRISTIN MARIE (PT)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:MEISEL
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 1:7315 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:RIVER HILLS
Mailing Address - State:WI
Mailing Address - Zip Code:53217-3320
Mailing Address - Country:US
Mailing Address - Phone:414-540-0517
Mailing Address - Fax:
Practice Address - Street 1:7315 N RIVER RD
Practice Address - Street 2:
Practice Address - City:RIVER HILLS
Practice Address - State:WI
Practice Address - Zip Code:53217-3320
Practice Address - Country:US
Practice Address - Phone:414-540-0517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5966-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist