Provider Demographics
NPI:1871024810
Name:BERTRAM, CURT (CPO)
Entity Type:Individual
Prefix:MR
First Name:CURT
Middle Name:
Last Name:BERTRAM
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W292N6880 DORN RD
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-9245
Mailing Address - Country:US
Mailing Address - Phone:262-366-6094
Mailing Address - Fax:
Practice Address - Street 1:W292N6880 DORN RD
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-9245
Practice Address - Country:US
Practice Address - Phone:262-366-6094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist