Bergold, Philip William

Bergold, Philip William is an sole proprietor health care provider with primary practice located at 5889 Riverside Dr , Greendale WI 53129-2817. 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. Bergold, Philip William can be contacted via phone (414) 940-7278.

Contact Information

Primary practice address
5889 Riverside Dr Greendale WI 53129-2817
Phone: (414) 940-7278
Fax: (414) 235-8448
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5058 Wisconsin

Profile Details

NPI number 1629073135
LBN Legal business name Bergold, Philip William
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 21st, 2005
Last updated Feb 7th, 2016 - about 9 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 1629073135 NPPES
Wisconsin MEDICAID 40377300

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