Individual
BILLIE J BRAATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, LAT
Contact information
Practice address
421 CAMELOT DR, FOND DU LAC, WI 54935-8335
(920) 923-7940
Mailing address
421 CAMELOT DR, FOND DU LAC, WI 54935-8335
(920) 923-7940
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
784039
WI
2255A2300X
Athletic Trainer
784039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36116700
—
WI
Enumeration date
01/16/2008
Last updated
01/16/2008
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