Healthcare Provider Details
I. General information
NPI: 1316230972
Provider Name (Legal Business Name): VENTURES UNLIMITED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2011
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 NORTH INDUSTRIAL BLVD.
SHELL LAKE WI
54871
US
IV. Provider business mailing address
P.O. BOX 623 110 NORTH INDUSTRIAL BLVD..
SHELL LAKE WI
54871
US
V. Phone/Fax
- Phone: 715-934-3035
- Fax: 715-934-3037
- Phone: 715-468-2939
- Fax: 715-468-4478
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 10204-146 |
| License Number State | WI |
VIII. Authorized Official
Name: MS.
KRISTIN
RAE
FRANE
Title or Position: CEO
Credential: M.S.
Phone: 715-468-2939