Provider Demographics
NPI:1821228446
Name:ASPIRUS EXTENDED SERVICES, INC.
Entity Type:Organization
Organization Name:ASPIRUS EXTENDED SERVICES, INC.
Other - Org Name:ASPIRUS OUTPATIENT THERAPY SERVICES - PHILLIPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REHAB MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BURTCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2600
Mailing Address - Street 1:603 PETERSON DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS
Mailing Address - State:WI
Mailing Address - Zip Code:54555-1430
Mailing Address - Country:US
Mailing Address - Phone:715-339-3103
Mailing Address - Fax:715-339-3153
Practice Address - Street 1:603 PETERSON DR
Practice Address - Street 2:
Practice Address - City:PHILLIPS
Practice Address - State:WI
Practice Address - Zip Code:54555-1430
Practice Address - Country:US
Practice Address - Phone:715-339-3103
Practice Address - Fax:715-339-3153
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPIRUS EXTENDED SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-16
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty