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Individual

HEATHER N.M. BOUGIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
N84W16889 MENOMONEE AVE, MENOMONEE FALLS, WI 53051-2810
(262) 251-7500
(262) 251-7128
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
(414) 247-4590

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4752
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40366900
WI
Enumeration date
06/29/2006
Last updated
07/08/2007
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