Individual
BETHANY J NODOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, CSCS
Contact information
Practice address
421 CAMELOT DR, FOND DU LAC, WI 54935-8335
(920) 923-7940
Mailing address
421 CAMELOT DR, FOND DU LAC, WI 54935-8335
(920) 923-7940
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9529-024
WI
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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