Bandholz, Gina Marie
Bandholz, Gina Marie is an individual health care provider with primary practice located at N112W17975 Mequon Rd , Germantown WI 53022-2425. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Bandholz, Gina Marie can be contacted via phone (262) 532-7600.Contact Information
Primary practice address
N112W17975 Mequon Rd
Germantown WI 53022-2425
Phone: (262) 532-7600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 4942-024 | Wisconsin |
Profile Details
| NPI number | 1336293448 |
|---|---|
| LBN Legal business name | Bandholz, Gina Marie |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2007 |
| Last updated | Dec 7th, 2021 - about 5 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 | 1336293448 | NPPES |
| Wisconsin | MEDICAID | 1336293448 |
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