Healthcare Provider Details

I. General information

NPI: 1770188856
Provider Name (Legal Business Name): ORTHOPAEDIC CENTERS OF WISCONSIN S C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4002 SCHOFIELD AVE STE 2
WESTON WI
54476-3809
US

IV. Provider business mailing address

3901 STEWART AVE
WAUSAU WI
54401-3948
US

V. Phone/Fax

Practice location:
  • Phone: 715-847-2382
  • Fax:
Mailing address:
  • Phone: 715-907-0900
  • Fax: 715-803-6977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH HOFFMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 715-907-0900