Dodge, Deanna Marie

Dodge, Deanna Marie is an individual health care provider with primary practice located at 3821 S Chicago Ave , South Milwaukee WI 53172-3712. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Dodge, Deanna Marie can be contacted via phone (414) 762-7336.

Contact Information

Primary practice address
3821 S Chicago Ave South Milwaukee WI 53172-3712
Phone: (414) 762-7336
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 522019 Wisconsin

Profile Details

NPI number 1144434168
LBN Legal business name Dodge, Deanna Marie
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2007
Last updated Mar 7th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144434168 NPPES
Wisconsin MEDICAID 36106700

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