Provider Demographics
NPI:1437828068
Name:NORTHWOODS SPORT & HAND, INC
Entity Type:Organization
Organization Name:NORTHWOODS SPORT & HAND, INC
Other - Org Name:NORTHWOODS THERAPY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TJ
Authorized Official - Middle Name:
Authorized Official - Last Name:NERENG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:715-839-9266
Mailing Address - Street 1:1200 OAKLEAF WAY STE B
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-2245
Mailing Address - Country:US
Mailing Address - Phone:715-839-9266
Mailing Address - Fax:715-839-8761
Practice Address - Street 1:1855 125TH ST
Practice Address - Street 2:
Practice Address - City:LAKE HALLIE
Practice Address - State:WI
Practice Address - Zip Code:54729-6306
Practice Address - Country:US
Practice Address - Phone:715-839-9266
Practice Address - Fax:715-839-8761
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWOODS SPORT & HAND, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-08
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy