Organization
CONTINENCE & PELVIC WELLNESS CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERESE D HILDENBRAND OTR (OWNER VP)
(262) 240-1202
Entity
Organization
Contact information
Practice address
1516 W MEQUON RD, SUITE 102, MEQUON, WI 53092
(262) 240-1202
(262) 240-1205
Mailing address
1516 W MEQUON RD, SUITE 102, MEQUON, WI 53092
(262) 240-1202
(262) 240-1205
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41012700
—
WI
Enumeration date
07/25/2006
Last updated
01/28/2014
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