Provider Demographics
NPI:1770188856
Name:ORTHOPAEDIC CENTERS OF WISCONSIN, S.C.
Entity Type:Organization
Organization Name:ORTHOPAEDIC CENTERS OF WISCONSIN, S.C.
Other - Org Name:PRO PHYSICAL THERAPY AND HAND CENTER OF WAUSAU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-907-0900
Mailing Address - Street 1:3901 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-3948
Mailing Address - Country:US
Mailing Address - Phone:715-907-0900
Mailing Address - Fax:715-803-6977
Practice Address - Street 1:4002 SCHOFIELD AVE STE 2
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-3809
Practice Address - Country:US
Practice Address - Phone:715-847-2382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPAEDIC CENTERS OF WISCONSIN, S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-04
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty