Individual
MRS. ELIZABETH A BRADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1415 GREEN DR, HAZEL GREEN, WI 53811-9549
(734) 755-0139
Mailing address
1415 GREEN DR, HAZEL GREEN, WI 53811-9549
(734) 755-0139
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
005186
IA
225100000X
Physical Therapist
Primary
12902
WI
225100000X
Physical Therapist
9808
MN
225100000X
Physical Therapist
PT011233
GA
Other
Enumeration date
09/12/2013
Last updated
12/31/2014
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