Provider Demographics
NPI:1023190204
Name:GEAR, WILLIAM (PHD, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:GEAR
Suffix:
Gender:M
Credentials:PHD, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 LAU ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54302-3445
Mailing Address - Country:US
Mailing Address - Phone:920-465-2266
Mailing Address - Fax:
Practice Address - Street 1:2420 NICOLET DR DEPT OF
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-7003
Practice Address - Country:US
Practice Address - Phone:920-465-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2184-392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer