Organization
BACK & BODY THERAPEUTIC TOUCH, LLC
Active
Other names
Back & Body Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
TINA L SWANKE OTR (OWNER)
(920) 229-0955
Entity
Organization
Contact information
Practice address
147 N STATE ST, BERLIN, WI 54923-1621
(920) 229-0955
Mailing address
N6681 COUNTY RD N, PRINCETON, WI 54968-9323
(920) 229-0955
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
729-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40729700
—
WI
Enumeration date
10/14/2006
Last updated
08/22/2020
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