Individual
JEFFREY BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-8151
Mailing address
W9350 FRIENDSHIP RD, SHAWANO, WI 54166-6319
(715) 526-2887
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5274-24
WI
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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