| Doctor Name: | MR. SEVERINO TAYSON VILLANUEVA |
| NPI Number: | 1083669352 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 4975-024 |
| Business Practice Address: | 2323 N Lake Dr Milwaukee, WI - 532114508 |
| Business Phone Number: | 4142911067 |
| Business Fax Number: | 4142911077 |
| Mailing Address: | 3926 W Minnesota Ave, FRANKLIN |
| State: | WI |
| Postal Code: | 531328763 |
| Phone Number: | 4144230373 |
| Fax Number: | |
| NPI Enumeration Date: | 05/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 4975-024 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |