Individual
JOHN A HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
8911 NORTH PORT WASHINGTON ROAD, SPORT CLINIC PHYSICAL THERAPY INC, BAYSIDE, WI 53217
(414) 351-5794
(414) 351-2770
Mailing address
7206 W FREISTADT ROAD, MEQUON, WI 53092-1018
(262) 512-9977
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1987024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40078100
—
WI
Enumeration date
08/10/2006
Last updated
07/08/2007
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