IndividualActive
Conner Funnell
NPI 1649109240 · Pediatric Physical Therapist · Portage, WI
Provider details
- NPI number
- 1649109240
- Entity type
- Individual
- Primary specialty
- Pediatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
626 E Slifer St
Portage, WI 53901-1224
Phone: (608) 745-5400
Approximate (ZIP-level) locationGet directions
Mailing address
4214 School Rd
Madison, WI 53704-1611
Registry dates
- Enumerated
- 2026-05-18
- Last updated
- 2026-05-18
- Certified
- 2026-05-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.