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General NPI Number Information
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NPI Number | 1174683155
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI VALLEY PHYSICAL REHABILITATION S.C.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | N1418 TIMBER VALLEY RD
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City | LA CROSSE
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State | WI
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Zip | 54601-2172
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Country | US
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Telephone | 608-787-6386
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Fax | 608-788-4543
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Provider Business Mailing Address
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Address Line | N1418 TIMBER VALLEY RD
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City | LA CROSSE
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State | WI
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Zip | 54601-2172
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Country | US
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Telephone | 608-787-6386
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Fax | 608-788-4543
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. KATHLEEN SEITZ
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Credential |
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Telephone | 608-787-6386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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