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NPI Profile for BRADLEY T BODNER in WAUSAU, WI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1093767808 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 05/17/2006 | |
| Last updated | 12/15/2021 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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BRADLEY T BODNER
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BRADLEY T BODNER, PA-C