MR. Anthony Jack Ettmayer JR., PT

NPI #1457649352 in Port Washington, Wisconsin

Provider Information

NPI Number: 1457649352
Entity Type: Individual
Name: MR. Anthony Jack Ettmayer JR., PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Jul 13, 2011
Last Updated: Jul 13, 2011

Practice Location

Address: 1119 N WISCONSIN ST
City: Port Washington
State: Wisconsin
ZIP Code: 53074-1209
Phone: (262) 284-5892

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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