Timothy Frederic Boerger BS, ATC

NPI 1023385937 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1023385937
Gender Male
Enumeration Date 11/20/2011
Last Updated 06/20/2016
Entity Type Individual
Active Over 5 years ago
Practice Location
1250 W WISCONSIN AVE
MILWAUKEE WI, 53233-2225, US
Phone (414) 288-5069
Fax
Business Location
PO BOX 1881
MILWAUKEE WI, 53201-1881, US
Phone (414) 288-6256
Fax
Toxanomy
Taxonomy Code 2255A2300X
License State Illinois
License Number 096.003134
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According to our database, Mr. Timothy Frederic Boerger BS, ATC NPI is 1023385937, taxonomy code is 2255A2300X and license number is 096.003134, license state is located at Illinois. Timothy Frederic Boerger BS, ATC physically located at 1250 W Wisconsin Ave, Milwaukee WI, 53233-2225. NPI Number Timothy Frederic Boerger BS, ATC has the Individual type.

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1023385937 NPI number is provided on an as is basis without warranty of any kind. 1023385937 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy Frederic Boerger BS, ATC are for informational purposes only.