Individual
MARY RUDOLPH THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4425 N PORT WASHINGTON RD, GLENDALE, WI 53212-1082
(414) 961-3598
Mailing address
664 N 74TH ST, WAUWATOSA, WI 53213-3664
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5561-024
WI
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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