Provider Demographics
NPI:1871063818
Name:DREW, ROCHELE
Entity type:Individual
Prefix:
First Name:ROCHELE
Middle Name:
Last Name:DREW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 W WATERTOWN PLANK RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3595
Mailing Address - Country:US
Mailing Address - Phone:414-805-8656
Mailing Address - Fax:414-805-8655
Practice Address - Street 1:8700 W WATERTOWN PLANK RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3595
Practice Address - Country:US
Practice Address - Phone:414-805-8565
Practice Address - Fax:414-805-8655
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI110002251H1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman Factors