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1124507165
BRADLEY THOMAS ILK
WAUWATOSA, WI
NPI
1124507165
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 2740-19)
Enumeration Date
2018-08-10
Last Update Date
2018-08-10
Business Address
BRADLEY THOMAS ILK
2626 N 76TH ST STE 105
WAUWATOSA, WI 53213-1137
Phone number: 414-774-7794
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Mailing Address
BRADLEY THOMAS ILK
2626 N 76TH ST STE 105
WAUWATOSA, WI 53213-1137
Phone number: 414-774-7794
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