Dodge, Mark

Dodge, Mark is an individual health care provider with primary practice located at 701 Willow St , Peshtigo WI 54157-1165. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Dodge, Mark can be contacted via phone (715) 582-0144.

Contact Information

Primary practice address
701 Willow St Peshtigo WI 54157-1165
Phone: (715) 582-0144
Fax: (715) 582-0803
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2053 Wisconsin

Profile Details

NPI number 1295183580
LBN Legal business name Dodge, Mark
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2016
Last updated May 27th, 2016 - about 9 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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