De Valk, Demotris Dwayne
De Valk, Demotris Dwayne is an individual health care provider with primary practice located at 13250 Washington Ave , Mount Pleasant WI 53177-1516. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. De Valk, Demotris Dwayne can be contacted via phone (262) 799-8330.Contact Information
Primary practice address
13250 Washington Ave
Mount Pleasant WI 53177-1516
Phone: (262) 799-8330
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner | 225400000X | ||
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 16408 | Wisconsin |
Profile Details
| NPI number | 1235797341 |
|---|---|
| LBN Legal business name | De Valk, Demotris Dwayne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2019 |
| Last updated | Nov 2nd, 2023 - about 2 years 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 | 1235797341 | NPPES |
| Other | 911-39026-02 | 80840 |
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