Individual
JILL FRAUNDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
275 REGENCY CT, SUITE 200, BROOKFIELD, WI 53045-6168
(262) 798-9650
Mailing address
PO BOX 611, BROOKFIELD, WI 53008-0611
(262) 798-9650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4662-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4662-024
PHYSICAL THERAPIST STATE LICENSE
WI
Enumeration date
08/18/2008
Last updated
08/18/2008
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