Individual
MR. BRAD SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1836 SOUTH AVENUE, LA CROSSE, WI 54601
(608) 782-7300
Mailing address
1836 SOUTH AVENUE, LA CROSSE, WI 54601
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12256
WI
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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