Van Dewater, Edward V

Van Dewater, Edward V is an individual health care provider with primary practice located at 6222 Washington Ave , Mount Pleasant WI 53406-3948. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Van Dewater, Edward V can be contacted via phone (262) 884-6418.

Contact Information

Primary practice address
6222 Washington Ave Mount Pleasant WI 53406-3948
Phone: (262) 884-6418
Fax: (262) 884-6489
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 9822-024 Wisconsin

Profile Details

NPI number 1083772529
LBN Legal business name Van Dewater, Edward V
Credentials MPT CSCS
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Nov 21st, 2021 - about 4 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 1083772529 NPPES
Wisconsin MEDICAID 40407400
Wisconsin Other 9822-024

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