Individual
DAVID MICHAEL NISSENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT MA LAT
Contact information
Practice address
1118 MAIN ST STE A, CROSS PLAINS, WI 53528-9477
(608) 413-0550
(608) 413-0552
Mailing address
1118 MAIN ST STE A, CROSS PLAINS, WI 53528-9477
(608) 413-0550
(608) 413-0552
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6391024
WI
2255A2300X
Athletic Trainer
209039
WI
Other
Enumeration date
03/23/2006
Last updated
05/31/2025
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