MEDICARE: BERNARD TODD PRATTE PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	3621-024	WI

General Provider Information

NPI Number	:	1427011832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNARD TODD PRATTE PT

Provider Business Mailing Address
First Line	:	10335 W OKLAHOMA AVE
Second Line	:	202
City	:	MILWAUKEE
State	:	WI
Zip	:	53227-4100
Country	:	US
Telephone Number	:	414-545-2561
Fax Number	:	414-545-2561

Provider Business Practice Location Address
First Line	:	10335 W OKLAHOMA AVE
Second Line	:	202
City	:	MILWAUKEE
State	:	WI
Zip	:	53227-4100
Country	:	US
Telephone Number	:	414-545-2561
Fax Number	:	414-545-2561

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	05/23/2012

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