| Doctor Name: | MISS SHANNON M TALATZKO |
| NPI Number: | 1528346897 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 11732-024 |
| Business Practice Address: | 146 E Geneva Sq East Side Bldg Lake Geneva, WI - 531479694 |
| Business Phone Number: | 4146476280 |
| Business Fax Number: | |
| Mailing Address: | W165s7431 Bellview Dr, MUSKEGO |
| State: | WI |
| Postal Code: | 531508840 |
| Phone Number: | 4144125370 |
| Fax Number: | |
| NPI Enumeration Date: | 08/03/2011 |
| NPI Last Update Date: | 02/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 11732-024 |
| 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 |