Individual
BRIAN J DVORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
118 W MAPLE AVE, BEAVER DAM, WI 53916-2104
(920) 356-1000
(920) 356-0719
Mailing address
118 W MAPLE AVE, BEAVER DAM, WI 53916-2104
(920) 356-1000
(920) 356-0719
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
10392
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40452200
—
WI
01
—
61270
DEAN HEALTH SYSTEMS
WI
Enumeration date
08/17/2006
Last updated
12/20/2011
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