Individual
MS. BRIDGET BODENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9200 W LOOMIS RD, FRANKLIN, WI 53132-8887
(414) 529-9232
(414) 529-9292
Mailing address
9200 W LOOMIS RD, FRANKLIN, WI 53132-8887
(414) 529-9232
(414) 529-9292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3263-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41920100
—
WI
Enumeration date
04/11/2014
Last updated
11/23/2021
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