NPI 1558871525

Kheson Kaballa Madison

Practitioner Physical Therapy Assistant Wisconsin Rapids, WI

Practice location

Address: 555 W Grand Ave, Wisconsin Rapids, WI 54495-2784
Phone: (715) 424-4682
Fax: (715) 424-4614

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 2403-19 (WI)

Other Physical Therapy Assistant providers in Wisconsin →

Registry record

NPI: 1558871525
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Oct 2017
Record last updated: 4 Oct 2017

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.