Heather Marie Radomski
Individual provider Active NPI Physical Therapist · Miwaukee, WI
NPI 1972033801 · NPPES record last updated Jun 13, 2017
Key facts
- NPI
- 1972033801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 12859-24 (WI)
- Practice address
- 2900 W Oklahoma Ave
Miwaukee, WI 53215 - Phone
- (414) 222-4070
- NPI assigned
- Jun 13, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12859-24 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12859-24 | WI | Yes |
Addresses
Primary practice location
2900 W Oklahoma Ave
Miwaukee, WI 53215
Mailing address
3600 S 90TH St
Milwaukee, WI 53228-1536
Phone (262) 510-6460
Other providers in Miwaukee, WI
All providers in Miwaukee, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.