Individual
BRADLEY THOMAS ILK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2626 N 76TH ST STE 105, WAUWATOSA, WI 53213-1137
(414) 774-7794
(414) 607-3971
Mailing address
2626 N 76TH ST STE 105, WAUWATOSA, WI 53213-1137
(414) 774-7794
(414) 607-3971
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2740-19
WI
Other
Enumeration date
08/10/2018
Last updated
08/10/2018
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