Organization Name: | OCONTO PHYSICAL THERAPY, LLC |
NPI Number: | 1124016407 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CYNTHIA L WILLETTE (BILLING MANAGER) |
Mailing Address: | 300 N Broadway Suite 3c Green Bay |
State: | WI US |
Postal Code: | 543032702 |
Phone Number: | 9204377246 |
Fax Number: | 9204371511 |
NPI Enumeration Date: | 10/11/2005 |
NPI Last Update Date: | 08/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2368 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |