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Individual

MICHAEL R HAMBEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
524 COUNTY ROAD 34 EAST, DODGE CENTER, MN 55927
(920) 858-7427
(920) 830-6707
Mailing address
1650 TRI PARK WAY, SUITE A, APPLETON, WI 54914-1652
(920) 830-6697
(920) 830-6707

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004288
IA
225100000X
Physical Therapist
10443-024
WI
225100000X
Physical Therapist
Primary
6959
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001286020
MEDICARE
WI
01
001986652
MEDICARE
WI
01
117378
SECURITY HEALTH PLAN
WI
05
40458900
WI
01
64-07697
MEDICA
WI
Enumeration date
07/28/2005
Last updated
03/03/2011
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