Provider Demographics
NPI:1568933224
Name:GEORGE, WILLIAM ARISTIDES IV (ATC/LAT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ARISTIDES
Last Name:GEORGE
Suffix:IV
Gender:M
Credentials:ATC/LAT
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Mailing Address - Street 1:8700 WATERTOWN PLANK RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3595
Mailing Address - Country:US
Mailing Address - Phone:414-805-7190
Mailing Address - Fax:
Practice Address - Street 1:8700 W WATERTOWN PLANK RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3595
Practice Address - Country:US
Practice Address - Phone:414-805-7111
Practice Address - Fax:414-805-8655
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2021-09-22
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Provider Licenses
StateLicense IDTaxonomies
WI1308-392081S0010X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine