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Organization
THERAPY WIZARDS CORP
Active
Organization
THERAPY WIZARDS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD SAMANIEGO PT (OWNER)
(847) 322-6551
Entity
Organization
Contact information
Practice address
3727 W WISCONSIN AVE, MILWAUKEE, WI 53208-3182
(414) 810-7246
Mailing address
2713 ELIM AVE., ZION, IL 60099-2640
(847) 322-6551
(800) 364-0886
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
488612
WI
225100000X
Physical Therapist
070014146
IL
225100000X
Physical Therapist
Primary
1015624
WI
Other
Enumeration date
10/29/2009
Last updated
03/26/2013
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