Healthcare Provider Details

I. General information

NPI: 1114143781
Provider Name (Legal Business Name): MEDICAL SUPPORT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13203 GLOBE DR SUITE 111
MOUNT PLEASANT WI
53177-1616
US

IV. Provider business mailing address

13203 GLOBE DR SUITE 111
MOUNT PLEASANT WI
53177-1616
US

V. Phone/Fax

Practice location:
  • Phone: 262-287-0090
  • Fax: 262-923-1939
Mailing address:
  • Phone: 262-287-0090
  • Fax: 262-923-1939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDA K NIEMELA
Title or Position: CEO
Credential: PT
Phone: 262-287-0090