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Contact Information

ADAM R KETTERHAGEN, PT DPT
5340 WASHINGTON AVE
MOUNT PLEASANT, WI53406
 Phone: 262-638-1272
 Fax: 262-638-1287
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for ADAM R KETTERHAGEN · (Male)

NPI Number 1114273372
Status Active
Credentials PT DPT
Entity Individual
Enumeration date 07/25/2012
Last updated 01/04/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # 9895
  • WI License # 12113-24
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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