Zachary Lovdahl
Individual provider Active NPI Physical Therapy Assistant · Dousman, WI
NPI 1679289243 · NPPES record last updated Jan 26, 2023
Key facts
- NPI
- 1679289243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2750 (WI)
- Practice address
- 410 N Main St
Dousman, WI 53118-8853 - Phone
- (800) 848-5306
- NPI assigned
- Jan 26, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2750 | WI | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2750 | WI | Yes |
Addresses
Primary practice location
410 N Main St
Dousman, WI 53118-8853
Mailing address
2115 Irving PL
Waukesha, WI 53188-2237
Phone (262) 880-5669
Other providers in Dousman, WI
- Joann Krofta
- Richard Labinski
- Erika Lacombe
- Lad Lake, Inc.
- Sarah Nicole Lind
- Debra Makinen
- Judy Rene Martinez
- Masonic Center for Health and Rehab Inc.
- Aaron Tyler Moore
- Dennis James Neuenfeldt
All providers in Dousman, WI · Physical Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.