Doctor Name: | BRIAN JOHN BEDALOV |
NPI Number: | 1235173782 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.P.T. |
License Number: | 6538 |
Business Practice Address: | 2329 Silvernail Rd Pewaukee, WI - 530725402 |
Business Phone Number: | 2628966967 |
Business Fax Number: | 2628969449 |
Mailing Address: | 2329 Silvernail Rd, PEWAUKEE |
State: | WI |
Postal Code: | 530725402 |
Phone Number: | 2628966967 |
Fax Number: | 2628969449 |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 6538 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |