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Individual

EVAN VELDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
506 N CLARK ST, BLACK CREEK, WI 54106-9720
(920) 265-4477
Mailing address
506 N CLARK ST, BLACK CREEK, WI 54106-9720

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1270-19
WI

Other

Enumeration date
08/27/2008
Last updated
08/27/2008
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