Provider Demographics
NPI:1134488240
Name:ZWIEG, DAVID LLOYD (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LLOYD
Last Name:ZWIEG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W10177 HICKORY BAY RD
Mailing Address - Street 2:
Mailing Address - City:FOX LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:53933-9632
Mailing Address - Country:US
Mailing Address - Phone:920-928-2275
Mailing Address - Fax:
Practice Address - Street 1:W10177 HICKORY BAY RD
Practice Address - Street 2:
Practice Address - City:FOX LAKE
Practice Address - State:WI
Practice Address - Zip Code:53933-9632
Practice Address - Country:US
Practice Address - Phone:920-928-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2325225100000X
NCP8482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist