Bradley T Bodner PA-C

NPI 1093767808 - Physician Assistant - 363AS0400X

NPI Details
NPI 1093767808
Gender Male
Enumeration Date 05/17/2006
Last Updated 04/13/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
2800 WESTHILL DR
SUITE 200
WAUSAU WI, 54401-3771, US
Phone (715) 843-1000
Fax
Business Location
2800 WESTHILL DRIVE
SUITE 200
WAUSAU WI, 54402-3770, US
Phone (715) 843-1000
Fax
Toxanomy
Taxonomy Code 363AS0400X
License State Wisconsin
License Number 1312-023
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According to our database, Bradley T Bodner PA-C NPI is 1093767808, taxonomy code is 363AS0400X and license number is 1312-023, license state is located at Wisconsin. Bradley T Bodner PA-C physically located at 2800 Westhill Dr, Wausau WI, 54401-3771. NPI Number Bradley T Bodner PA-C has the Individual type.

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1093767808 NPI number is provided on an as is basis without warranty of any kind. 1093767808 is maintained by the National Plan & Provider Enumeration System. The contents of Bradley T Bodner PA-C are for informational purposes only.