Provider Demographics
NPI:1669165262
Name:ROMANSKI, ADAM NATHANIEL (DPT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:NATHANIEL
Last Name:ROMANSKI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E FLORIDA ST APT 108
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-1649
Mailing Address - Country:US
Mailing Address - Phone:216-650-5343
Mailing Address - Fax:
Practice Address - Street 1:3217 FIDDLERS CREEK DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3946
Practice Address - Country:US
Practice Address - Phone:262-832-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16362-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist