Individual ProviderSara Marie RadkePhysical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2305 San Luis Pl, Green Bay, WI 54304-5211(920) 494-2817PECOS EnrollmentBased on the most recent information from CMS, provider Sara Marie Radke does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1386916476Provider TypeIndividualFull NameRadke, Sara MarieCredentialPTAGenderFemaleSole ProprietorNoEnumeration Date2/3/2012Last Updated2/3/2012Contact InformationPractice LocationPractice Address2305 San Luis Pl, Green Bay, WI 54304-5211Phone(920) 494-2817FaxUnlisted FaxMailing LocationMailing Address850 Centennial Centennial Centre Blvd., Apt. 83, Hobart, WI 54155PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225200000XPrimaryDescriptionPhysical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1818-019Wisconsin