Doctor Name: | MRS. ELIZABETH MARIE MORTAG |
NPI Number: | 1134522170 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 12680-24 |
Business Practice Address: | 13105 Watertown Plank Rd Elm Grove, WI - 531222213 |
Business Phone Number: | 2627829850 |
Business Fax Number: | |
Mailing Address: | 18260 Astor Dr Apt 101, BROOKFIELD |
State: | WI |
Postal Code: | 530455695 |
Phone Number: | 3093604162 |
Fax Number: | |
NPI Enumeration Date: | 10/05/2014 |
NPI Last Update Date: | 10/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 12680-24 |
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 |