Organization
WISCONSIN REHABILITATION MEDICINE PROFESSIONALS, SC
Active
Organization
WISCONSIN REHABILITATION MEDICINE PROFESSIONALS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRIDHAR V VASUDEVAN M.D. (PRESIDENT)
(262) 285-3888
Entity
Organization
Contact information
Practice address
5200 LAKEVIEW RIDGE RD, BELGIUM, WI 53004-9423
(262) 285-3888
Mailing address
PO BOX 1790, BROOKFIELD, WI 53008-1790
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/14/2006
Last updated
11/24/2008
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