Provider Demographics
NPI:1174146690
Name:VALIGA, BRYCEN (MS, ATC)
Entity type:Individual
Prefix:MR
First Name:BRYCEN
Middle Name:
Last Name:VALIGA
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4477 S 113TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-2566
Mailing Address - Country:US
Mailing Address - Phone:715-340-5397
Mailing Address - Fax:
Practice Address - Street 1:4477 S 113TH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-2566
Practice Address - Country:US
Practice Address - Phone:715-340-5397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer