NPI 1699140814

Thaddeus Holgado, CO

Practitioner Orthotist Mequon, WI

Practice location

Address: 12075 Corporate Pkwy Suite 120, Mequon, WI 53092-2665
Phone: (844) 447-5894
Mailing address: 720 E. Butterfield Road Suite 180, Lombard, IL 60148

Registered specialties

Orthotist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X Licence 213000212 (IL)

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Registry record

NPI: 1699140814
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Dec 2015
Record last updated: 14 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.