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General NPI Number Information
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NPI Number | 1952086712
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Entity Type | Individual
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Provider Name | MADELINE BRADSHAW PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 1000 N 92ND ST
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City | MILWAUKEE
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State | WI
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Zip | 53226-3533
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Country | US
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Telephone | 414-750-1869
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Fax |
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Provider Business Mailing Address
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Address Line | W8379 WOODVIEW DR
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City | ONALASKA
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State | WI
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Zip | 54650-9761
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Country | US
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Telephone | 608-317-7992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 16425-24
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License Number State | WI
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