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Individual

MICHAEL A BRODZELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.S.

Contact information

Practice address
5595 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-2150
(262) 306-2151
Mailing address
5595 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-2150
(262) 306-2151

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1252
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40041900
WI
01
7742485
AETNA
WI
Enumeration date
06/20/2005
Last updated
11/03/2008
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