Clark, Dennis
Clark, Dennis is an individual health care provider with primary practice located at 1200 Oakleaf Way Ste B , Altoona WI 54720-2245. 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. Clark, Dennis can be contacted via phone (715) 839-9266.Contact Information
Primary practice address
1200 Oakleaf Way Ste B
Altoona WI 54720-2245
Phone: (715) 839-9266
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 3706 | Wisconsin |
Profile Details
| NPI number | 1730220518 |
|---|---|
| LBN Legal business name | Clark, Dennis |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 12th, 2007 |
| Last updated | Dec 1st, 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 | 1730220518 | NPPES |
| Wisconsin | MEDICAID | 40293800 |
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