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

Mitchell Kannal

Individual provider Physical Therapist · NPI 1255082350

Mitchell Kannal is a Physical Therapist in Private Practice in Kewaskum, Wisconsin. Qualified in 2016, 10 years ago. Practices with Froedtert Andthe Medical College of Wisconsin Community Physicians Inc, a 1,255-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
10
Licensed in
WI
In the registry since
2022

Practice location Address checks out

1701 Fond Du Lac Ave
Kewaskum, WI 53040-9129
Phone: (262) 626-4616
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 13543-24 (WI)

Record details

NPI number1255082350
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 11, 2022
Last updated in NPPESOctober 9, 2025
Certification dateOctober 9, 2025
Mailing address1701 Fond Du Lac Ave, Kewaskum, WI 53040-9129

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Froedtert Andthe Medical College Of Wisconsin Community Physicians Inc — 1255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Kewaskum