Provider Demographics
NPI:1497443576
Name:WAHL, DONALD FRANCIS (LMT)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:FRANCIS
Last Name:WAHL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33828 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-9295
Mailing Address - Country:US
Mailing Address - Phone:262-302-9727
Mailing Address - Fax:
Practice Address - Street 1:33828 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-9295
Practice Address - Country:US
Practice Address - Phone:262-302-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11105-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist