Organization
HOMETOWN SUPERIOR THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATIE JEAN SMITH DPT (PHYSICAL THERAPIST)
(715) 209-7559
Entity
Organization
Contact information
Practice address
16925 BADGER RD, MASON, WI 54856-9495
(715) 209-7559
(715) 804-4211
Mailing address
16925 BADGER RD, MASON, WI 54856-9495
(715) 209-7559
(715) 804-4211
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780840538
—
WI
Enumeration date
10/29/2018
Last updated
10/29/2018
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