Healthcare Provider Details

I. General information

NPI: 1699718924
Provider Name (Legal Business Name): STEVEN CHARLES STRAUB PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1518 METRO DR STE 108
SCHOFIELD WI
54476
US

IV. Provider business mailing address

4209 STETTIN DR
WAUSAU WI
54401
US

V. Phone/Fax

Practice location:
  • Phone: 715-359-8465
  • Fax: 715-359-8832
Mailing address:
  • Phone: 715-845-8669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5228024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: