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Organization
SHEBOYGAN SENIOR COM
Active
Organization
SHEBOYGAN SENIOR COM
Active
Other names
Rehab/KindredCare
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERYL ANN KNORR I PTA (PHYSICAL THERAPY ASSISTANT)
(920) 459-0637
Entity
Organization
Contact information
Practice address
307 LAKE DR, RANDOM LAKE, WI 53075-1764
(920) 447-3041
Mailing address
307 LAKE DR, RANDOM LAKE, WI 53075-1764
(920) 447-3041
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1862-19
WI
Other
Enumeration date
04/15/2013
Last updated
04/15/2013
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