Burton, Bradley Jack

Burton, Bradley Jack is an sole proprietor health care provider with primary practice located at 1700 W Stout St , Rice Lake WI 54868-5000. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Burton, Bradley Jack can be contacted via phone (715) 236-6408.

Contact Information

Primary practice address
1700 W Stout St Rice Lake WI 54868-5000
Phone: (715) 236-6408
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4515 Wisconsin

Profile Details

NPI number 1750553616
LBN Legal business name Burton, Bradley Jack
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2008
Last updated Mar 31st, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750553616 NPPES
Wisconsin MEDICAID 40266300

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