1295928232 NPI number — MS. KIMBERLY JOAN DECHANT DPT

Table of content: MS. KIMBERLY JOAN DECHANT DPT (NPI 1295928232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295928232 NPI number — MS. KIMBERLY JOAN DECHANT DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DECHANT
Provider First Name:
KIMBERLY
Provider Middle Name:
JOAN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RING
Provider Other First Name:
KIMBERLY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295928232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MARQUETTE PHYSICAL THERAPY CLINIC
Provider Second Line Business Mailing Address:
604 N 16TH ST CRAMER HALL 215
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53233-2117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-292-5268
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
604 N 16TH ST
Provider Second Line Business Practice Location Address:
CRAMER HALL 104
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53233-2117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-288-6754
Provider Business Practice Location Address Fax Number:
414-288-6079
Provider Enumeration Date:
08/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  10852 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 10852-24 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com