NPI 1043569833

Nichole Shannon Bliesner, PTA

Practitioner Physical Therapy Assistant Milwaukee, WI

Practice location

Address: 2448 S 102nd St STE. 340, Milwaukee, WI 53227-2466
Phone: (414) 329-2428
Mailing address: 1434 Blaine Ave, Racine, WI 53405-3310

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 1561-19 (WI)

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Registry record

NPI: 1043569833
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Sep 2012
Record last updated: 7 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.