Healthcare Provider Details

I. General information

NPI: 1922938406
Provider Name (Legal Business Name): BONITA JO BROMLEY
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: BONNIE BROMLEY

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7106 SOUTH AVE
MIDDLETON WI
53562-3299
US

IV. Provider business mailing address

445 DUNHILL DR
VERONA WI
53593-2106
US

V. Phone/Fax

Practice location:
  • Phone: 608-829-9006
  • Fax:
Mailing address:
  • Phone: 608-438-8030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: