Provider Demographics
NPI:1235407834
Name:THUNSTEDT, ERIC DOUGLAS (MA, CES, RCEP)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DOUGLAS
Last Name:THUNSTEDT
Suffix:
Gender:M
Credentials:MA, CES, RCEP
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Mailing Address - Street 1:507 S. MAIN STREET
Mailing Address - Street 2:VERNON MEMORIAL HEALTHCARE
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-2059
Mailing Address - Country:US
Mailing Address - Phone:608-637-4497
Mailing Address - Fax:608-638-5023
Practice Address - Street 1:507 S. MAIN STREET
Practice Address - Street 2:VERNON MEMORIAL HEALTHCARE
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-2059
Practice Address - Country:US
Practice Address - Phone:608-637-4497
Practice Address - Fax:608-638-5023
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist