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Individual

DAVID BOLLIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5752 TOKAY BLVD, MADISON, WI 53719-1237
(608) 417-8050
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11697-024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100025789
WI
Enumeration date
09/18/2012
Last updated
12/29/2014
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