Vervoort, Richard

Vervoort, Richard is an individual health care provider with primary practice located at 550 N Military Ave , Green Bay WI 54303-4569. He recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as his primary health care specialty. Vervoort, Richard can be contacted via phone (920) 497-4600.

Contact Information

Primary practice address
550 N Military Ave Green Bay WI 54303-4569
Phone: (920) 497-4600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X 1264-060 Wisconsin

Profile Details

NPI number 1912195652
LBN Legal business name Vervoort, Richard
Credentials H.I.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 9th, 2007
Last updated Oct 9th, 2007 - about 18 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 1912195652 NPPES
Wisconsin MEDICAID 42839000

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