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Organization

SPORT & SPINE CLINIC LP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD BINSTEIN JD (VP,AUTHORIZED OFFICIAL)
(713) 297-7000
Entity
Organization

Contact information

Practice address
4107 BARBICAN AVE, SUITE 260, WESTON, WI 54476-4143
(715) 359-8465
(715) 359-8832
Mailing address
327 N 17TH AVE STE 7, WAUSAU, WI 54401-4283

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary

Other

Enumeration date
07/01/2006
Last updated
01/17/2022
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