Basic Information
| Provider Information | |||||||||
| NPI: | 1619316502 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YUNTO | ||||||||
| FirstName: | BRITTNEY | ||||||||
| MiddleName: | NICHOLE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | D.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | N77W16228 COUNTRYSIDE DR | ||||||||
| Address2: | |||||||||
| City: | MENOMONEE FALLS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530517401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2624425943 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1119 N WISCONSIN ST | ||||||||
| Address2: | |||||||||
| City: | PORT WASHINGTON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530741209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2622845892 | ||||||||
| FaxNumber: | 2622840234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2013 | ||||||||
| LastUpdateDate: | 06/24/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 12319-024 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.