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Individual

MRS. BETH MARIE GUNDRUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
W166S7122 STILL MEADOW CT, MUSKEGO, WI 53150-7404
(414) 422-4624
Mailing address
W166S7122 STILL MEADOW CT, MUSKEGO, WI 53150-7404
(414) 422-4624

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4872-024
WI

Other

Enumeration date
01/21/2010
Last updated
01/21/2010
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