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

Samuel Mbaki Moke

Individual provider Physical Therapy Assistant · NPI 1629841721

Samuel Mbaki Moke is a Physical Therapy Assistant in De Pere, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2023

Practice location Address checks out

250 S 9th St
De Pere, WI 54115-3919
Phone: (715) 582-2247
Fax: (920) 983-5174
Show map & directions

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

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 4122-19 (WI)

Record details

NPI number1629841721
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 1, 2023
Last updated in NPPESNovember 1, 2023
Certification dateNovember 1, 2023
Mailing address119 N Jackson St, Green Bay, WI 54301-4934

Other providers in De Pere