Johnson, Ebba M
Johnson, Ebba M is an individual health care provider with primary practice located at 524 74Th Street , Kenosha WI 53143. 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. Johnson, Ebba M can be contacted via phone (262) 496-0258.Contact Information
Primary practice address
524 74Th Street
Kenosha WI 53143
Phone: (262) 496-0258
Fax: (262) 657-7784
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 2940 | Wisconsin |
Profile Details
| NPI number | 1497929012 |
|---|---|
| LBN Legal business name | Johnson, Ebba M |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 15th, 2008 |
| Last updated | Apr 2nd, 2009 - about 16 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 | 1497929012 | NPPES |
| Wisconsin | MEDICAID | 40167500 |
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