Individual
MRS. GINA MARIE BANDHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
N112W17975 MEQUON RD, GERMANTOWN, WI 53022-2425
(262) 532-7600
Mailing address
1327 WINDY KNOLL DR, HUBERTUS, WI 53033-9302
(262) 628-3608
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4942-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336293448
—
WI
Enumeration date
01/23/2007
Last updated
12/07/2021
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