Provider Demographics
NPI:1770703928
Name:ORTHOPLUS LLC
Entity type:Organization
Organization Name:ORTHOPLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT CFMT LAC
Authorized Official - Phone:414-774-3870
Mailing Address - Street 1:8605 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-4760
Mailing Address - Country:US
Mailing Address - Phone:414-774-3870
Mailing Address - Fax:414-257-2436
Practice Address - Street 1:8605 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-4760
Practice Address - Country:US
Practice Address - Phone:414-774-3870
Practice Address - Fax:414-257-2436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI412055171100000X
WI3259024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
$$$$$$$$$OtherSOCIAL SECURITY NUMBER