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Organization

BACK IN ACTION REHABILITATION, S.C.

Active
Parent organization
BACK IN ACTION REHABILITATION SC
Organization subpart
Yes

Provider details

NPI number
Legal business name
BACK IN ACTION REHABILITATION SC
Authorized official
SHARON WUNSCH (OFFICE MANAGER)
(920) 922-7776
Entity
Organization

Contact information

Practice address
N8218 STATE ROAD 28, MAYVILLE, WI 53050-2126
(920) 387-9000
Mailing address
103 S PIONEER RD # 100, FOND DU LAC, WI 54935-3871

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225X00000X
Occupational Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41220600
WI
Enumeration date
05/29/2007
Last updated
10/26/2010
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