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1114929064
SOUTHPORT REHAB ASSOCIATES, INC
KENOSHA, WI
NPI
1114929064
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Entity Type
Organization
Authorized Contact
WILLIAM H LETSOM
President
262-694-3977
Organization Subpart ?
No
Primary Taxonomy
261QR0400X Clinic/Center, Rehabilitation
Enumeration Date
2005-08-11
Last Update Date
2008-04-10
Business Address
SOUTHPORT REHAB ASSOCIATES, INC
7201 GREEN BAY RD
KENOSHA, WI 53142-3522
Phone number: 262-694-3977
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Mailing Address
SOUTHPORT REHAB ASSOCIATES, INC
7201 GREEN BAY RD
KENOSHA, WI 53142-3522
Phone number: 262-694-3977
Copy
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