Organization
TAC II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA WHITE NEE PT (OWNER)
(815) 341-5979
Entity
Organization
Contact information
Practice address
5202 EASTPARK BLVD STE 112, MADISON, WI 53718-2151
(815) 341-5979
Mailing address
5202 EASTPARK BLVD STE 112, MADISON, WI 53718-2151
(815) 341-5979
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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