Doctor Name: | MR. MARK RICHARD VRIEZE |
NPI Number: | 1366609414 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 4331 |
Business Practice Address: | 1100 N Main St Lakeview Medical Center Rice Lake, WI - 548681238 |
Business Phone Number: | 7152366246 |
Business Fax Number: | 7152366578 |
Mailing Address: | 1100 N Main St, Lakeview Medical Center RICE LAKE |
State: | WI |
Postal Code: | 548681238 |
Phone Number: | 7152366246 |
Fax Number: | 7152366578 |
NPI Enumeration Date: | 05/16/2008 |
NPI Last Update Date: | 05/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 4331 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
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 |