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Contact Information

JASON C GATLIN, M.P.T.
200 EAST TYRANNENA ROAD
THERAPY AND SPORT CENTER
LAKE MILLS, WI53551
 Phone: 920-648-8170
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for JASON C GATLIN · (Male)

NPI # 1245256015
Status Active
Credentials M.P.T.
Entity Individual
Enumeration date 07/14/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 10409-024
  • WI Medicaid 40472500
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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