Provider Demographics
NPI:1578515755
Name:MUELLER THERAPY, INC.
Entity Type:Organization
Organization Name:MUELLER THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JUNGE
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:920-994-9700
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:RANDOM LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:53075-0323
Mailing Address - Country:US
Mailing Address - Phone:920-207-3550
Mailing Address - Fax:920-994-8466
Practice Address - Street 1:402 FIRST ST.
Practice Address - Street 2:
Practice Address - City:RANDOM LAKE
Practice Address - State:WI
Practice Address - Zip Code:53075-1272
Practice Address - Country:US
Practice Address - Phone:920-994-9700
Practice Address - Fax:920-994-8466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI326-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000080125Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
WIWI1024Medicare PIN
WIWI1023Medicare PIN