Provider Demographics
NPI:1003943572
Name:SOBUSH, DENNIS CHESTER (PT, MA, DPT, CCS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CHESTER
Last Name:SOBUSH
Suffix:
Gender:M
Credentials:PT, MA, DPT, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 S 120TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-1882
Mailing Address - Country:US
Mailing Address - Phone:414-546-2667
Mailing Address - Fax:
Practice Address - Street 1:3920 S 120TH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-1882
Practice Address - Country:US
Practice Address - Phone:414-546-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1436-0242251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary