Individual
BROOKE OBERMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5219 88TH AVE, KENOSHA, WI 53144-7468
(262) 653-0850
Mailing address
28613 MARTHA CT, WATERFORD, WI 53185-2661
(414) 708-2206
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
986-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40198900
—
WI
Enumeration date
01/05/2007
Last updated
04/13/2017
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