Michael Lynn Bernarde PTA

NPI 1699955286 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1699955286
Gender Male
Enumeration Date 11/12/2007
Last Updated 11/12/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1351 WISCONSIN RIVER DR
PORT EDWARDS WI, 54469-1041, US
Phone (715) 885-8300
Fax (715) 885-8350
Business Location
550 AIRPORT AVE
WISCONSIN RAPIDS WI, 54494-6514, US
Phone (715) 424-5331
Fax
Toxanomy
Taxonomy Code 225200000X
License State Wisconsin
License Number 943-019
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According to our database, Michael Lynn Bernarde PTA NPI is 1699955286, taxonomy code is 225200000X and license number is 943-019, license state is located at Wisconsin. Michael Lynn Bernarde PTA physically located at 1351 Wisconsin River Dr, Port Edwards WI, 54469-1041. NPI Number Michael Lynn Bernarde PTA has the Individual type.

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1699955286 NPI number is provided on an as is basis without warranty of any kind. 1699955286 is maintained by the National Plan & Provider Enumeration System. The contents of Michael Lynn Bernarde PTA are for informational purposes only.