Healthcare Provider Details

I. General information

NPI: 1457089500
Provider Name (Legal Business Name): JUSTIN G DROESSLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 PLUM RD STE A
WRIGHTSTOWN WI
54180-7302
US

IV. Provider business mailing address

202 PLUM RD STE A
WRIGHTSTOWN WI
54180-7302
US

V. Phone/Fax

Practice location:
  • Phone: 920-502-7986
  • Fax:
Mailing address:
  • Phone: 920-502-7986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15928-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: