Individual
BREANNA LEE COLVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
502 S HIGH ST, RANDOLPH, WI 53956-1499
(570) 620-6135
Mailing address
212 S HENRY ST APT 2, MADISON, WI 53703-4434
(570) 620-6135
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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