# PHYSICAL MEDICINE REHABILITATION INDEPENDENT SERVICES, SC

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

## Provider details

- **NPI number:** 1932343670
- **Authorized official:** WILLIAM E FOWLER MD (PRESIDENT)
- **Authorized official phone:** (608) 843-5074

## Contact information

- **Practice address:** 4863 ENCHANTED VALLEY RD, MIDDLETON, WI 53562-4118
- **Practice address phone:** (608) 843-5074
- **Mailing address:** 4863 ENCHANTED VALLEY RD, MIDDLETON, WI 53562-4118
- **Mailing address phone:** (608) 843-5074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/24/2009
- **Last updated:** 04/24/2009