De Witt, Jeanette Marie
De Witt, Jeanette Marie is an individual health care provider with primary practice located at 6233 Bankers Rd Ste 12 , Mount Pleasant WI 53403-9700. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. De Witt, Jeanette Marie can be contacted via phone (262) 358-6730.Contact Information
Primary practice address
6233 Bankers Rd Ste 12
Mount Pleasant WI 53403-9700
Phone: (262) 358-6730
Fax: (866) 245-8064
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 008334 | Ohio |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 11903-24 | Wisconsin |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 1315-39 | Wisconsin |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 001071 | Ohio |
Profile Details
| NPI number | 1528087442 |
|---|---|
| LBN Legal business name | De Witt, Jeanette Marie |
| Credentials | PT, ATC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Mar 1st, 2017 - about 8 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 | 1528087442 | NPPES |
| Wisconsin | Other | 859400073 | MEDICARE |
| Wisconsin | MEDICAID | 1528087442 | MEDICARE |
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