Doctor Name: | KELLY DORFNER |
NPI Number: | 1174984702 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PTA |
License Number: | 4547 |
Business Practice Address: | 1125 E Fitzsimmons Rd Oak Creek, WI - 531545231 |
Business Phone Number: | 4142134263 |
Business Fax Number: | |
Mailing Address: | 1125 E Fitzsimmons Rd, OAK CREEK |
State: | WI |
Postal Code: | 531545231 |
Phone Number: | 4142134263 |
Fax Number: | |
NPI Enumeration Date: | 03/09/2016 |
NPI Last Update Date: | 03/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 4547 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |