Provider Demographics
NPI:1831729276
Name:ASPEN ORTHOPEDIC AND REHABILATION SPECALIST
Entity type:Organization
Organization Name:ASPEN ORTHOPEDIC AND REHABILATION SPECALIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-395-4163
Mailing Address - Street 1:8907 S HOWELL AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-4461
Mailing Address - Country:US
Mailing Address - Phone:262-395-4141
Mailing Address - Fax:262-395-4159
Practice Address - Street 1:8907 S HOWELL AVE STE 800
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-4461
Practice Address - Country:US
Practice Address - Phone:262-395-4141
Practice Address - Fax:262-395-4159
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPEN ORTHOPEDIC AND REHABILATION SPECALIST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty