Elmendorf, John L

Elmendorf, John L is an individual health care provider with primary practice located at 1125 N 13Th St , Sheboygan WI 53081-3281. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as his primary health care specialty. Elmendorf, John L can be contacted via phone (920) 803-1617.

Contact Information

Primary practice address
1125 N 13Th St Sheboygan WI 53081-3281
Phone: (920) 803-1617
Fax: (920) 803-1622
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 2810-026 Wisconsin

Profile Details

NPI number 1790966604
LBN Legal business name Elmendorf, John L
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2007
Last updated Oct 10th, 2022 - about 4 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 1790966604 NPPES
Wisconsin MEDICAID 41813000
Wisconsin MEDICAID 40794400

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