Individual
MICHELLE SUZANNE BRAITHWAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2900 W OKLAHOMA AVE STE 518, MILWAUKEE, WI 53215-4330
(414) 649-3250
Mailing address
1300 S GREEN BAY RD STE 205, MOUNT PLEASANT, WI 53406-4469
(262) 898-3930
(262) 898-3933
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10400509-2401
UT
225100000X
Physical Therapist
Primary
14545-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100088859
—
WI
Enumeration date
09/01/2017
Last updated
11/16/2020
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