Provider Demographics
NPI:1982202180
Name:HS OCCUPATIONAL WELLNESS LLC
Entity Type:Organization
Organization Name:HS OCCUPATIONAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:712-277-4442
Mailing Address - Street 1:3100 S LAKEPORT ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4222
Mailing Address - Country:US
Mailing Address - Phone:712-277-4442
Mailing Address - Fax:712-202-0578
Practice Address - Street 1:3100 S LAKEPORT ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4222
Practice Address - Country:US
Practice Address - Phone:712-277-4442
Practice Address - Fax:712-202-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty