Healthcare Provider Details

I. General information

NPI: 1871232959
Provider Name (Legal Business Name): ALEXANDER SEEFELD DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N8218 STATE ROAD 28
MAYVILLE WI
53050-2126
US

IV. Provider business mailing address

103 S PIONEER RD STE 100
FOND DU LAC WI
54935-3800
US

V. Phone/Fax

Practice location:
  • Phone: 920-387-9000
  • Fax:
Mailing address:
  • Phone: 920-922-7776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: