Provider Demographics
NPI:1558462432
Name:CENTER FOR MUSCLE & JOINT THERAPY INC
Entity Type:Organization
Organization Name:CENTER FOR MUSCLE & JOINT THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:RAUZI
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:715-394-6355
Mailing Address - Street 1:823 BELKNAP ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-2960
Mailing Address - Country:US
Mailing Address - Phone:715-394-6355
Mailing Address - Fax:715-394-2191
Practice Address - Street 1:823 BELKNAP ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-2960
Practice Address - Country:US
Practice Address - Phone:715-394-6355
Practice Address - Fax:715-394-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4148024225100000X
MN4361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN64-23290OtherMEDICA
WI40192300Medicaid
WI8402385OtherCIGNA
1B411CEOtherBCBS
WI000085912Medicare PIN