Basic Information
| Provider Information | |||||||||
| NPI: | 1023216454 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAPANEK | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D, MPT, ATC, LAT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1881 | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532011881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4142885069 | ||||||||
| FaxNumber: | 4142886079 | ||||||||
| Practice Location | |||||||||
| Address1: | 604 N 16TH ST | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532332117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4142885069 | ||||||||
| FaxNumber: | 4142886079 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 6360024 | WI | X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2255A2300X | 517039 | WI | X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.