Individual
MRS. MICHAEL MACCLARENCE BASHFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2025 E NEWPORT AVE, MILWAUKEE, WI 53211-2906
(414) 298-6798
Mailing address
1153 E SYLVAN AVE, WHITEFISH BAY, WI 53217-5301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1376024
WI
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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