# ORTHOPEDIC & SPINE THERAPY OF WAUPACA SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548298284
- **Authorized official:** PAUL STEVEN BARNETT PT (OWNER AND PRESIDENT)
- **Authorized official phone:** (920) 257-2000

## Contact information

- **Practice address:** E3277 APPLE TREE LANE, WAUPACA, WI 54981
- **Practice address phone:** (715) 256-0358
- **Practice address fax:** (715) 256-0393
- **Mailing address:** 4000 N. PROVIDENCE AVENUE, APPLETON, WI 54913-8018
- **Mailing address phone:** (920) 257-2000
- **Mailing address fax:** (920) 257-2004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | WI | Yes |

## Other

- **Enumeration date:** 06/29/2006
- **Last updated:** 08/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 128853 | HEALTH PARTNERS | WI |
| 05 | — | 40426000 | — | WI |
| 01 | — | 4136293001 | AMERICHOICE | WI |
| 05 | — | 41754700 | — | WI |
| 01 | — | 610109700 | US DEPARTMENT OF LABOR | WI |