Individual
MARK ADAM FRAAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2323 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 298-6700
Mailing address
2323 N LAKE DR, MILWAUKEE, WI 53211-4508
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1758-019
WI
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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