Individual
DR. BRADLEY ZENOR JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1190 E PARADISE DR, WEST BEND, WI 53095
(262) 306-6319
Mailing address
306 BLUFFVIEW CT, PORTAGE, WI 53901-1512
(608) 617-9424
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
1415624
WI
225100000X
Physical Therapist
Primary
14156
WI
Other
Enumeration date
05/23/2018
Last updated
06/20/2018
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