Healthcare Provider Details

I. General information

NPI: 1205862133
Provider Name (Legal Business Name): HAMMER REHAB & FITNESS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 MAIN ST STE C&D
MUKWONAGO WI
53149-1752
US

IV. Provider business mailing address

221 MUIRFIELD CT
NORTH PRAIRIE WI
53153-9617
US

V. Phone/Fax

Practice location:
  • Phone: 262-662-9760
  • Fax: 262-662-9761
Mailing address:
  • Phone: 262-662-9760
  • Fax: 262-662-9761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN L. HAMMER
Title or Position: PRESIDENT
Credential: PT
Phone: 262-662-9760