Pomplun, Jody L

Pomplun, Jody L is an individual health care provider with primary practice located at 845 South Main Street Suite 120, Fond Du Lac WI 54935. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as her primary health care specialty. Pomplun, Jody L can be contacted via phone (920) 322-0447.

Contact Information

Primary practice address
845 South Main Street Suite 120 Fond Du Lac WI 54935
Phone: (920) 322-0447
Fax: (920) 322-1362
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X 1030-027 Wisconsin

Profile Details

NPI number 1063605970
LBN Legal business name Pomplun, Jody L
Credentials Certified Occupational Therapy Assistant (COTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2007
Last updated Feb 1st, 2010 - about 14 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 1063605970 NPPES
Wisconsin MEDICAID 40792400

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