Individual
MARY BRAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
W3930 CO RD NN, ELKHORN, WI 53121
(262) 741-3036
Mailing address
N7768 LAURA LANE, ELKHORN, WI 53121
(262) 742-3048
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4969-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40241600
—
WI
Enumeration date
05/02/2007
Last updated
07/08/2007
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