Organization
MIND BODY OT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN M BAUMANN OT (OWNER)
(920) 763-3534
Entity
Organization
Contact information
Practice address
201 GATEWAY DR., STE 300, BEAVER DAM, WI 53916-9176
(920) 763-3534
Mailing address
W9018 COUNTY RD S, BEAVER DAM, WI 53916-9680
(920) 763-3534
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/20/2019
Last updated
03/21/2019
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