Provider Demographics
NPI:1174189864
Name:DRAMM, DAVID J (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:DRAMM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7404 MINERAL POINT RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1710
Mailing Address - Country:US
Mailing Address - Phone:608-709-7511
Mailing Address - Fax:608-709-2785
Practice Address - Street 1:7404 MINERAL POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1710
Practice Address - Country:US
Practice Address - Phone:608-709-7511
Practice Address - Fax:608-709-2785
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60964671225100000X
COPTL.0017664225100000X
WI15755-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1174189864Medicaid