Individual
CARL HENRY FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6171
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11849-024
WI
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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