| NPI | 1174977433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE MELENBACKER Administrator 715-344-2167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 225XH1200X Occupational Therapist, Hand | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2022-08-26 |