Individual
MRS. BROOKE MICHAEL MENGWASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5405024
WI
Other
Enumeration date
02/15/2009
Last updated
02/15/2009
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