| NPI | 1669213419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA E ERICKSON-MICHELS Practice Administrator 715-204-4097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2025-06-24 |