NPI Registry.org

Edward V Van Dewater

NPI Registration Record

Provider / OrganizationNPIDate Certified
EDWARD V VAN DEWATER10837725292021-11-21

Edward V Van De Water PT [M] graduated in 2001 and primarily specializes in Physical Therapy.

Edward V Van Dewater is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1083772529. Registration indicates Edward V Van Dewater is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapist (Physical Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)

PECOS ID2062316979
Entity TypeIndividual
Provider NameMr. Edward V Van Dewater MPT CSCS
Practice Office Address6222 WASHINGTON AVE
MOUNT PLEASANT, WI US
Practice Office Telephone2628846418
Practice Office Fax2628846489
Mailing Address6222 WASHINGTON AVE
MOUNT PLEASANT, WI 534063948 US
Business Telephone2628846418
Business Fax2628846489
HPT Codes
CodePractice
License No
State
225100000X PRIMARY
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
Physical Therapist

Speech/Occupational/Physical Therapy/Chiropractor

Physical Therapist
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
9822-024
WI
OPI Codes
9822-024 OTHER WI STATE LICENSE N
40407400 MEDICAID WI
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