| NPI | 1003165804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI CZERNEJEWSKI CEO 262-510-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, (Licence: WI 368154) | |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2013-03-29 |