Individual
MITCHELL JAMES FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-0505
(414) 805-2934
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-0505
(414) 805-2934
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1867-19
WI
363A00000X
Physician Assistant
Primary
5580
WI
Other
Enumeration date
06/13/2012
Last updated
11/05/2021
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