Individual
BRADLEY A TYTHCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
N53W24950 S CORPORATE CIR, SUITE 2, SUSSEX, WI 53089-4374
(126) 224-6300
(262) 246-4255
Mailing address
615 QUINLAN DR, UNIT G, PEWAUKEE, WI 53072-1809
(262) 746-9785
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9592
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40465300
—
WI
Enumeration date
04/25/2006
Last updated
02/02/2015
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