Brent Bode, PT
Physical Therapist in Milwaukee, WI. Individual provider (NPI-1).
NPI number1003084005
StatusActive
Last updated in NPPESAug 3, 2010
Details
- NPI
- 1003084005
- Entity type
- Individual (NPI-1)
- Name
- Mr. Brent Bode
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 13, 2008
- Last updated
- Aug 3, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 10968 | WI | Yes |
Practice location
807 N Jefferson StMilwaukee, WI 53202-8150
Phone 414-224-8219 · Fax 414-224-8246
Mailing address
1177 Quail CtSuite 200
Pewaukee, WI 53072-3790
Phone 262-695-3057 · Fax 262-695-3063
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