Provider Demographics
NPI:1427011832
Name:PRATTE, BERNARD TODD (PT)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:TODD
Last Name:PRATTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10335 W OKLAHOMA AVE
Mailing Address - Street 2:202
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227-4100
Mailing Address - Country:US
Mailing Address - Phone:414-545-2561
Mailing Address - Fax:414-545-2561
Practice Address - Street 1:10335 W OKLAHOMA AVE
Practice Address - Street 2:202
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4100
Practice Address - Country:US
Practice Address - Phone:414-545-2561
Practice Address - Fax:414-545-2561
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3621-0242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP29413Medicare UPIN
WI000186679Medicare ID - Type UnspecifiedMEDICARE NUMBER