Bothfeld, Nathaniel S

Bothfeld, Nathaniel S is an individual health care provider with primary practice located at 1650 Lee Ln Occupation Health Ports & Family Medicine Center, Beloit WI 53511-3935. 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. Bothfeld, Nathaniel S can be contacted via phone (608) 362-0211.

Contact Information

Primary practice address
1650 Lee Ln Occupation Health Ports & Family Medicine Center Beloit WI 53511-3935
Phone: (608) 362-0211
Fax: (608) 364-4670
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 9109 Minnesota
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 12179-24 Wisconsin

Profile Details

NPI number 1124376892
LBN Legal business name Bothfeld, Nathaniel S
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2012
Last updated Mar 1st, 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 1124376892 NPPES
Minnesota Other 9109 MINNESOTA BOARD OF PHYSICALTHERAPY

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