Organization
SUMMIT REHABILITATION SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM HANSEN MD (OWNER/PRESIDENT)
(414) 649-7709
Entity
Organization
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, SUITE #106, MILWAUKEE, WI 53215-3677
(414) 349-7709
Mailing address
2901 W KINNICKINNIC RIVER PKWY, SUITE #106, MILWAUKEE, WI 53215-3677
(414) 349-7709
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31921700
—
WI
Enumeration date
07/23/2006
Last updated
08/27/2010
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