Provider Demographics
NPI:1578853990
Name:HWPT
Entity Type:Organization
Organization Name:HWPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-695-6744
Mailing Address - Street 1:19035 W CAPITOL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-2755
Mailing Address - Country:US
Mailing Address - Phone:262-695-6744
Mailing Address - Fax:262-695-6466
Practice Address - Street 1:19035 W CAPITOL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2755
Practice Address - Country:US
Practice Address - Phone:262-695-6744
Practice Address - Fax:262-695-6466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy