Individual
DAVID N VAN DE WATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
6222 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3948
(262) 884-6418
(262) 884-6489
Mailing address
6222 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3948
(262) 884-6418
(262) 884-6489
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11232-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11232-024
PHYSICAL THERAPY LICENSE NUMBER
WI
Enumeration date
10/07/2009
Last updated
11/21/2021
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