Individual
BRANDON JOHN BIGELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2835 N GRANDVIEW BLVD STE 100, PEWAUKEE, WI 53072-5546
(262) 574-1100
(262) 574-5193
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16387-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247450
—
WI
Enumeration date
06/05/2023
Last updated
09/29/2024
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