Fetterer, River Lyn
Fetterer, River Lyn is an individual health care provider with primary practice located at 835 S Van Buren St , Green Bay WI 54301-3526. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Fetterer, River Lyn can be contacted via phone (920) 226-4143.Contact Information
Primary practice address
835 S Van Buren St
Green Bay WI 54301-3526
Phone: (920) 226-4143
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 13146-24 | Wisconsin |
Profile Details
| NPI number | 1093182404 |
|---|---|
| LBN Legal business name | Fetterer, River Lyn |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2015 |
| Last updated | Oct 23rd, 2015 - about 11 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 | 1093182404 | NPPES |
| Wisconsin | MEDICAID | 100048734 |
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