Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Connie J Blackwell, PTA

Individual provider Physical Therapy Assistant · NPI 1699823542

Connie J Blackwell, PTA is a Physical Therapy Assistant in Kenosha, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.

Licensed in
WI
In the registry since
2007
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

5219 88th Ave
Kenosha, WI 53144-7468
Phone: (262) 653-0850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 1326-019 (WI)

Record details

NPI number1699823542
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedJanuary 8, 2007
Last updated in NPPESApril 8, 2008

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