Deaver, Richard J.

Deaver, Richard J. is an sole proprietor health care provider with primary practice located at 7754 Braeger Rd , Three Lakes WI 54562-9207. 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. Deaver, Richard J. can be contacted via phone (715) 546-8026.

Contact Information

Primary practice address
7754 Braeger Rd Three Lakes WI 54562-9207
Phone: (715) 546-8026
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 963-024 Wisconsin

Profile Details

NPI number 1255508917
LBN Legal business name Deaver, Richard J.
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 13th, 2008
Last updated May 13th, 2008 - 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 1255508917 NPPES
Wisconsin MEDICAID 40100700

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