Provider Demographics
NPI:1487139259
Name:PFEILSTIFTER, JOELLYN R
Entity type:Individual
Prefix:
First Name:JOELLYN
Middle Name:R
Last Name:PFEILSTIFTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOELLYN
Other - Middle Name:R
Other - Last Name:ALWES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6643 WALTER RALEIGH LN
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-2200
Mailing Address - Country:US
Mailing Address - Phone:262-886-9665
Mailing Address - Fax:
Practice Address - Street 1:6222 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-3948
Practice Address - Country:US
Practice Address - Phone:262-884-6418
Practice Address - Fax:262-884-6489
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5677-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist