Mazur, Douglas

Mazur, Douglas is an individual health care provider with primary practice located at 224 Butternut St , West Bend WI 53095-4910. 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. Mazur, Douglas can be contacted via phone (262) 365-0650.

Contact Information

Primary practice address
224 Butternut St West Bend WI 53095-4910
Phone: (262) 365-0650
Fax: (262) 365-0651
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4798 Wisconsin

Profile Details

NPI number 1710097241
LBN Legal business name Mazur, Douglas
Credentials MS PT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 2007 - about 19 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 1710097241 NPPES
Wisconsin Other 4798 LICENSE NUMBER

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