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General NPI Number Information
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NPI Number | 1154564482
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Entity Type | Organization
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Legal Business Name | HANDISHOP INDUSTRIES, INC.
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 04/16/2009
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Provider Practice Location Address
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Address Line | 1411 N SUPERIOR AVE
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City | TOMAH
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State | WI
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Zip | 54660-1131
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Country | US
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Telephone | 608-372-3289
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Fax | 608-372-0770
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Provider Business Mailing Address
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Address Line | 1411 N SUPERIOR AVE
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City | TOMAH
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State | WI
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Zip | 54660-1131
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Country | US
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Telephone | 608-372-3289
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Fax | 608-372-0770
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | PATTY CLARK
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Credential |
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Telephone | 608-372-3289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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