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Organization
ORTHOPEDIC & SPINE THERAPY OF CLINTONVILLE, SC
Active
Organization
ORTHOPEDIC & SPINE THERAPY OF CLINTONVILLE, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL STEVEN BARNETT (OWNER-PRESIDENT)
(920) 257-2000
Entity
Organization
Contact information
Practice address
205 W GREEN BAY ST, SHAWANO, WI 54166-2333
(715) 526-5433
(715) 526-6930
Mailing address
4000 N. PROVIDENCE AVENUE, APPLETON, WI 54913-8018
(920) 257-2000
(920) 257-2004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019870005
AMERICHOICE
WI
01
—
128873
HEALTH PARTNERS
WI
05
—
40423300
—
WI
05
—
41746200
—
WI
01
—
CH3959
RAILROAD MEDICARE
WI
Enumeration date
08/23/2006
Last updated
06/21/2018
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