Healthcare Provider Details

I. General information

NPI: 1457038028
Provider Name (Legal Business Name): MICHAEL PATRICK BUEHLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 S 6TH ST
OAK CREEK WI
53154-2010
US

IV. Provider business mailing address

7901 S 6TH ST
OAK CREEK WI
53154-2010
US

V. Phone/Fax

Practice location:
  • Phone: 414-346-8350
  • Fax: 414-346-2904
Mailing address:
  • Phone: 414-346-8350
  • Fax: 414-346-2904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3221-19
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: