Individual
BRYAN CANFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100
(262) 329-2731
Mailing address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100
(262) 329-2731
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4880
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528002904
—
WI
05
—
40405900
—
WI
Enumeration date
06/15/2006
Last updated
09/20/2023
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