| NPI | 1720138514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL J BRICCO President 920-735-9234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| 224Z00000X Occupational Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2012-12-28 |