Individual
BRETT TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
90 OAK ST, PRAIRIE DU SAC, WI 53578-1554
(608) 643-7572
Mailing address
3205 LOTHEVILLE RD, MADISON, WI 53704-2701
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13746
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13746
WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
08/17/2017
Last updated
08/17/2017
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