# LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** (INACTIVE)LMC Club House PT, OT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215194907
- **Authorized official:** MS. JACQUELINE KLEIN (CFO)
- **Authorized official phone:** (715) 236-6129

## Contact information

- **Practice address:** 1100 N MAIN ST, RICE LAKE, WI 54868-1238
- **Practice address phone:** (715) 234-1515
- **Practice address fax:** (715) 234-4465
- **Mailing address:** 1100 N MAIN ST, RICE LAKE, WI 54868-1238
- **Mailing address phone:** (715) 234-1515
- **Mailing address fax:** (715) 234-4465

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 1562800 | WI | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | 1562800 | WI | — |

## Other

- **Enumeration date:** 05/20/2008
- **Last updated:** 11/20/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41214500 | — | WI |