| NPI | 1548322019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M BARON Business Owner 715-369-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 4433-024) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 62-039) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 434-039) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-11-15 |