# BACK IN ACTION REHABILITATION, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BACK IN ACTION REHABILITATION SC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740481779
- **Legal business name:** BACK IN ACTION REHABILITATION SC
- **Authorized official:** SHARON WUNSCH (OFFICE MANAGER)
- **Authorized official phone:** (920) 922-7776

## Contact information

- **Practice address:** N8218 STATE ROAD 28, MAYVILLE, WI 53050-2126
- **Practice address phone:** (920) 387-9000
- **Mailing address:** 103 S PIONEER RD \# 100, FOND DU LAC, WI 54935-3871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 05/29/2007
- **Last updated:** 10/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41220600 | — | WI |