Healthcare Provider Details

I. General information

NPI: 1093801532
Provider Name (Legal Business Name): JOSEPH WESLEY BRIDGES PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOE WESLEY BRIDGES PT

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7878 N 76TH ST
MILWAUKEE WI
53223-3914
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 414-586-5710
  • Fax: 414-586-5740
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1581
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17636
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: