Vanderkooi, Matthew J

Vanderkooi, Matthew J is an individual health care provider with primary practice located at 2639 New Pinery Rd Suite 2, Portage WI 53901-1110. 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. Vanderkooi, Matthew J can be contacted via phone (608) 742-9356.

Contact Information

Primary practice address
2639 New Pinery Rd Suite 2 Portage WI 53901-1110
Phone: (608) 742-9356
Fax: (608) 742-9358
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5434 Wisconsin

Profile Details

NPI number 1932180775
LBN Legal business name Vanderkooi, Matthew J
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 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 1932180775 NPPES
Wisconsin MEDICAID 40377900
Wisconsin Other P00230916

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