Individual
HEIDI ELIZABETH BARES WEIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5150 N PORT WASHINGTON RD, #130, GLENDALE, WI 53217-5474
(414) 418-6578
Mailing address
6650 W STATE ST, UNIT D 136, MILWAUKEE, WI 53213-2827
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10420-024
WI
225100000X
Physical Therapist
PT 24498
FL
Other
Enumeration date
04/06/2009
Last updated
05/17/2013
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