Individual
NICOLE BRUECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6902 PARKSIDE CIR, DEFOREST, WI 53532-2560
(608) 203-8880
Mailing address
6902 PARKSIDE CIR, DEFOREST, WI 53532-2560
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2419-19
WI
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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