Boettcher, Deanna
Boettcher, Deanna is an individual health care provider with primary practice located at 252 Mchenry St , Burlington WI 53105-1828. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Boettcher, Deanna can be contacted via phone (262) 763-2411.Contact Information
Primary practice address
252 Mchenry St
Burlington WI 53105-1828
Phone: (262) 763-2411
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 10036-7000 | Wisconsin |
Profile Details
| NPI number | 1477757482 |
|---|---|
| LBN Legal business name | Boettcher, Deanna |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2007 |
| Last updated | Jun 5th, 2024 - about 6 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477757482 | NPPES |
| Wisconsin | MEDICAID | 40390500 |
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