Individual
MRS. MICHELLE THERESE JOYCE PRUDLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2025 E NEWPORT AVE, MILWAUKEE, WI 53211-2906
(414) 961-4172
Mailing address
1300 MIEROW LN, BROOKFIELD, WI 53045-7813
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4781-024
WI
Other
Enumeration date
06/06/2006
Last updated
07/08/2007
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