Hendrickson, John A
Hendrickson, John A is an individual health care provider with primary practice located at 8911 North Port Washington Road Sport Clinic Physical Therapy Inc, Bayside WI 53217. 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. Hendrickson, John A can be contacted via phone (414) 351-5794.Contact Information
Primary practice address
8911 North Port Washington Road Sport Clinic Physical Therapy Inc
Bayside WI 53217
Phone: (414) 351-5794
Fax: (414) 351-2770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1987024 | Wisconsin |
Profile Details
| NPI number | 1700897279 |
|---|---|
| LBN Legal business name | Hendrickson, John A |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Jul 8th, 2007 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700897279 | NPPES |
| Wisconsin | MEDICAID | 40078100 |
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