Jason R Hollander, DPT

Individual provider Active NPI Physical Therapist · Lancaster, WI

NPI 1073772802 · NPPES record last updated Jun 6, 2008

Key facts

NPI
1073772802
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
10621-024 (WI)
Practice address
507 S Monroe St
Lancaster, WI 53813-2054
Phone
(608) 723-3236
Fax
(608) 723-3379
NPI assigned
Jun 6, 2008
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10621-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Regional Health Center, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10621-024 WI Yes

Addresses

Primary practice location

507 S Monroe St
Lancaster, WI 53813-2054

Mailing address

507 S Monroe St
Lancaster, WI 53813-2054
Phone (608) 723-3236

Other providers in Lancaster, WI

All providers in Lancaster, WI · Physical Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.