Organization
SB PHYSIATRY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOLIVEN C BAUTISTA MD (PRESIDENT/OWNER)
(414) 732-1503
Entity
Organization
Contact information
Practice address
201 N MAYFAIR RD FL 4, MILWAUKEE, WI 53226-4216
(414) 259-7246
Mailing address
3106 WEDGEWOOD DR, COLGATE, WI 53017-9570
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
01/08/2025
Last updated
03/06/2025
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