Provider Demographics
NPI:1104921154
Name:PFIZENMAIER, WILLIAM G (PT, ATC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:G
Last Name:PFIZENMAIER
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 LOUISIANA RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-8989
Mailing Address - Country:US
Mailing Address - Phone:785-242-7597
Mailing Address - Fax:785-229-8343
Practice Address - Street 1:1301 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3537
Practice Address - Country:US
Practice Address - Phone:785-229-8922
Practice Address - Fax:785-229-8344
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02431225100000X
KS24-001612255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer