Elmendorf, John L
Elmendorf, John L is an individual health care provider with primary practice located at 1125 N 13Th St , Sheboygan WI 53081-3281. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as his primary health care specialty. Elmendorf, John L can be contacted via phone (920) 803-1617.Contact Information
Primary practice address
1125 N 13Th St
Sheboygan WI 53081-3281
Phone: (920) 803-1617
Fax: (920) 803-1622
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 2810-026 | Wisconsin |
Profile Details
NPI number | 1790966604 |
---|---|
LBN Legal business name | Elmendorf, John L |
Credentials | OTR/L |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 19th, 2007 |
Last updated | Oct 10th, 2022 - about 3 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 | 1790966604 | NPPES |
Wisconsin | MEDICAID | 41813000 | |
Wisconsin | MEDICAID | 40794400 |
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