Individual
MS. BRENDA WILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
720 ACKLEY STREET, ANTIGO, WI 54409
(715) 623-2292
(715) 627-2660
Mailing address
720 ACKLEY STREET, ANTIGO, WI 54409
(715) 623-2350
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4614024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40217500
—
WI
01
—
4614024
LICENSE #
WI
Enumeration date
11/20/2006
Last updated
07/08/2007
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