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1083048243
MATTHEW GERARD HENDRICKSON
MILWAUKEE, WI
NPI
1083048243
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 2059-19)
Enumeration Date
2013-08-23
Last Update Date
2013-08-23
Business Address
-- MATTHEW GERARD HENDRICKSON PTA
10150 W NATIONAL AVE SUITE 150
MILWAUKEE, WI 53227-2145
Phone number: 800-439-7012
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Mailing Address
-- MATTHEW GERARD HENDRICKSON PTA
2914 MINERAL POINT AVE
JANESVILLE, WI 53548-3297
Phone number: 608-757-1061
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