Individual
TIMOTHY PHILIP VANBOGAERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9047 W GREENFIELD AVE, WEST ALLIS, WI 53214-2808
(414) 607-0910
(414) 607-0924
Mailing address
423 W VINE ST, MILWAUKEE, WI 53212-3607
(630) 542-4154
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2086-19
WI
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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