Mark Frederick Wollum in Beaver Dam - Physical Therapist
Mark Frederick Wollum - NPI 1275745614
Mark Frederick Wollum is a Physical Therapist in Beaver Dam, Wisconsin. Mark Frederick Wollum practices all healthcare services and medical treatments related to Physical Therapist. The NPI Number for Mark Frederick Wollum is 1275745614. The last update date is 2007-07-08.
Mark Frederick Wollum's current location address is 108 Smith Dr, Beaver Dam, Wisconsin. You can contact this provider via phone number 9208878748. The mailing address for Mark Frederick Wollum is 108 Smith Dr, Beaver Dam, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Frederick Wollum |
|---|---|
| Address | 108 Smith Dr, Beaver Dam, Wisconsin |
| Phone Number | 9208878748 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | P.T. |
NPI Number Detail
| NPI Number | 1275745614 |
|---|---|
| Provider Enumeration Date | 2007-05-06 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 108 Smith Dr |
|---|---|
| City | Beaver Dam |
| State | Wisconsin (WI) |
| Post Code | 539162746 |
| Phone Number | 9208878748 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physical Therapist |
|---|---|
| Taxonomy | 225100000X |
| Licence No | 3568-024 |
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Definition: Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and per |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 40311800 | WI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Mark Frederick Wollum by the Centers for Medicare & Medicaid Services (CMS)?
The Mark Frederick Wollum has been assigned the NPI (National Provider Identifier) 1275745614. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Mark Frederick Wollum's physical address?
The Mark Frederick Wollum is physically located at 108 Smith Dr, in the city of Beaver Dam, WI, with the postal code 539162746.
What is Mark Frederick Wollum's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mark Frederick Wollum is Physical Therapist, and the taxonomy classification code that categorizes this area of expertise is 225100000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1275745614 to Mark Frederick Wollum?
The Mark Frederick Wollum received its 1275745614 assignment from the Centers for Medicare & Medicaid Services on 2007-05-06.
As of what date were the details pertaining to Mark Frederick Wollum last refreshed?
The information related to the Mark Frederick Wollum, including its address, specialty, and other relevant details, was last updated on 2007-07-08.