Nicole Bruecker

NPI #1720459597 in Deforest, Wisconsin

Provider Information

NPI Number: 1720459597
Entity Type: Individual
Name: Nicole Bruecker
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Oct 19, 2015
Last Updated: Oct 19, 2015

Practice Location

Address: 6902 PARKSIDE CIR
City: Deforest
State: Wisconsin
ZIP Code: 53532-2560
Phone: (608) 203-8880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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