Healthcare Provider Details

I. General information

NPI: 1669672911
Provider Name (Legal Business Name): ST CROIX THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 STERBENZ DR
HUDSON WI
54016-8327
US

IV. Provider business mailing address

742 STERBENZ DR
HUDSON WI
54016-8327
US

V. Phone/Fax

Practice location:
  • Phone: 715-386-2128
  • Fax: 715-386-6119
Mailing address:
  • Phone: 715-386-2128
  • Fax: 715-386-6119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: AMY NASERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 715-386-2128