Johansen, Wayne A

Johansen, Wayne A is an sole proprietor health care provider with primary practice located at 626 14Th St , Baraboo WI 53913-1535. 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. Johansen, Wayne A can be contacted via phone (608) 356-2334.

Contact Information

Primary practice address
626 14Th St Baraboo WI 53913-1535
Phone: (608) 356-2334
Fax: (608) 356-2636
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 987 Wisconsin

Profile Details

NPI number 1629064126
LBN Legal business name Johansen, Wayne A
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2005
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629064126 NPPES
Wisconsin Other 1028602 PHYSICIANS PLUS INS CORP
Wisconsin MEDICAID 40414400 PHYSICIANS PLUS INS CORP
Wisconsin Other W006005 PHYSICIANS PLUS INS CORP
Wisconsin MEDICAID 40119700 PHYSICIANS PLUS INS CORP
Wisconsin Other 39-1598907-01 PHYSICIANS PLUS INS CORP

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