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Organization
COUNTRY KIDS INC.
Active
Organization
COUNTRY KIDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA KAFKA OTR (EXECUTIVE DIRECTOR)
(920) 339-0700
Entity
Organization
Contact information
Practice address
1142 ORLANDO DR, DE PERE, WI 54115-9484
(920) 339-0700
(920) 330-0278
Mailing address
1142 ORLANDO DR, DE PERE, WI 54115-9484
(920) 339-0700
(920) 330-0278
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
NULL
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
NULL
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
NULL
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
NULL
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
NULL
261QH0700X
Hearing and Speech Clinic/Center
—
NULL
261QP2000X
Physical Therapy Clinic/Center
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
—
NULL
Other
Enumeration date
09/16/2006
Last updated
08/28/2008
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