Diane Fortek, PTA
NPI #1376883280 in Brookfield, Wisconsin
Provider Information
- NPI Number
- 1376883280
- Entity Type
- Individual
- Name
- Diane Fortek, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Mar 1, 2013
- Last Updated
- Feb 11, 2017
Practice Location
- Address
- 19395 W CAPITOL DR STE 200
- City
- Brookfield
- State
- Wisconsin
- ZIP Code
- 53045-2736
- Phone
- (414) 327-6603
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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