Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 10662-024 | WI |
N | 2251G0304X | Physical Therapist - Geriatrics | 10662-024 | WI |
NPI | 1285848200 |
---|---|
Provider Name | Eric Martin Kauffmann |
First Address | Altoona, WI 54720-2551 |
Second Address | Altoona, WI 54720-1378 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36117900 | (05) | WI |