Individual
MATTHEW GERARD HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
10150 W NATIONAL AVE, SUITE 150, MILWAUKEE, WI 53227-2145
(800) 439-7012
(800) 882-0886
Mailing address
2914 MINERAL POINT AVE, JANESVILLE, WI 53548-3297
(608) 757-1061
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2059-19
WI
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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