Individual
MICHEAL E CEIZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
134 CORPORATE DR, BEAVER DAM, WI 53916-3116
(920) 356-1000
(920) 356-0719
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-2200
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
6203
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1034219
PHYSICIANS PLUS
WI
05
—
40349200
—
WI
01
—
61271
DEAN HEALTH SYSTEMS
WI
01
—
P00064733
RAILROAD MEDICARE
WI
Enumeration date
08/17/2006
Last updated
02/17/2022
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