Doctor Name: | MRS. STACY LYNN CANNARIATO |
NPI Number: | 1689954323 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 4919-24 |
Business Practice Address: | 5700 Mockingbird Ln Greendale, WI - 531291442 |
Business Phone Number: | 4144231399 |
Business Fax Number: | |
Mailing Address: | 13706 W Ferguson Rd, NEW BERLIN |
State: | WI |
Postal Code: | 531512512 |
Phone Number: | 2627943318 |
Fax Number: | |
NPI Enumeration Date: | 08/25/2011 |
NPI Last Update Date: | 08/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 4919-24 |
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 |