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1093012734
BEAU BOEDECKER
MILWAUKEE, WI
NPI
1093012734
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WI 2701-23)
Enumeration Date
2011-02-15
Last Update Date
2022-01-03
Business Address
Mr. BEAU BOEDECKER PA-C
2801 W KINNICKINNIC RIVER PKWY STE 550
MILWAUKEE, WI 53215-3696
Phone number: 414-385-7150
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Mailing Address
Mr. BEAU BOEDECKER PA-C
6250 THORNRIDGE LN
GREENDALE, WI 53129-2651
Phone number: 414-303-8332
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