Fernandez, Greg
Fernandez, Greg is an sole proprietor health care provider with primary practice located at 2225 Wisconsin Ave Ste 100 , Grafton WI 53024-2608. 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. Fernandez, Greg can be contacted via phone (262) 474-0063.Contact Information
Primary practice address
2225 Wisconsin Ave Ste 100
Grafton WI 53024-2608
Phone: (262) 474-0063
Fax: (262) 222-6281
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 11288 | Wisconsin |
Profile Details
| NPI number | 1215481148 |
|---|---|
| LBN Legal business name | Fernandez, Greg |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2016 |
| Last updated | Sep 27th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215481148 | NPPES |
| Wisconsin | MEDICAID | 1215481148 |
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