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Search › Wisconsin › 224Z00000X

Mitchell Vandenboogard

NPI 1992274211 · on the registry since 2018 · sole proprietor

Practice

Address
200 S 9th St
De Pere, WI 54115
Phone
(920) 338-4145
Organisation at this address
Tdr Inc
Rennes Health And Rehab
Rennes Therapy Service, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
46

Registry record

Primary taxonomy
224Z00000X
224Z00000X
Licence states on file
WY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-11-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin