Individual
TONIA MARIE BRANDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
321 RIVERSIDE DR, PEWAUKEE, WI 53072-4612
(262) 691-2300
Mailing address
472 COTTONWOOD AVE, HARTLAND, WI 53029-2302
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2694-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40791400
—
WI
Enumeration date
05/23/2007
Last updated
07/08/2007
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