Dodge, Mark
Dodge, Mark is an individual health care provider with primary practice located at 701 Willow St , Peshtigo WI 54157-1165. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Dodge, Mark can be contacted via phone (715) 582-0144.Contact Information
Primary practice address
701 Willow St
Peshtigo WI 54157-1165
Phone: (715) 582-0144
Fax: (715) 582-0803
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | 2053 | Wisconsin |
Profile Details
| NPI number | 1295183580 |
|---|---|
| LBN Legal business name | Dodge, Mark |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2016 |
| Last updated | May 27th, 2016 - about 10 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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