| Doctor Name: | MR. JOHANNES RENZE SIKKEMA |
| NPI Number: | 1275861866 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DOCTOR OF PHYSICAL T |
| License Number: | PT36208 |
| Business Practice Address: | 120 W Pearl Ave Jackson, WY - 830018657 |
| Business Phone Number: | 3077349129 |
| Business Fax Number: | 3077341427 |
| Mailing Address: | Po Box 8857, JACKSON |
| State: | WY |
| Postal Code: | 830028857 |
| Phone Number: | 3077349129 |
| Fax Number: | 3077341427 |
| NPI Enumeration Date: | 11/19/2009 |
| NPI Last Update Date: | 08/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT36208 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |