Organization
SPORT AND SPINE CLINIC OF FORT ATKINSON LIMITED PARTNERSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNA KING JD (VP, AUTHORIZED OFFICIAL)
(713) 297-7000
Entity
Organization
Contact information
Practice address
480 VILLAGE WALK LN, UNIT 1, JOHNSON CREEK, WI 53038-9462
(920) 699-4201
(920) 699-4204
Mailing address
1300 W SAM HOUSTON PKWY S, SUITE 300, HOUSTON, TX 77042-2447
(713) 297-7000
(713) 297-7090
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/14/2007
Last updated
08/22/2020
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