Individual
MATTHEW HALEY BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
W173N10915 BERNIES WAY, GERMANTOWN, WI 53022-4043
(262) 509-3300
Mailing address
W173N10915 BERNIES WAY, GERMANTOWN, WI 53022-4043
(262) 509-3300
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3055-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154442515
—
WI
Enumeration date
01/19/2021
Last updated
01/19/2021
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