Provider Demographics
NPI:1639115686
Name:RAUZI, JAMES GERARD (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:GERARD
Last Name:RAUZI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4148-24225100000X
WI4148024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40192300Medicaid
85912Medicare ID - Type Unspecified