| Doctor Name: | WILLIAM VAN SISTINE |
| NPI Number: | 1942312269 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 1714-24 |
| Business Practice Address: | 1130 N Westfield St Oshkosh, WI - 549023217 |
| Business Phone Number: | 9202372164 |
| Business Fax Number: | |
| Mailing Address: | 2521 Crest Ln, GREEN BAY |
| State: | WI |
| Postal Code: | 543024801 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1714-24 |
| 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 |