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General NPI Number Information
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NPI Number | 1194611939
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE ORTHOPAEDICS SC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 6804 GREEN BAY RD STE 108
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City | KENOSHA
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State | WI
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Zip | 53142-1451
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Country | US
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Telephone | 262-764-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 7401 104TH AVE STE 110
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City | KENOSHA
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State | WI
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Zip | 53142-7845
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Country | US
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Telephone | 262-764-5891
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | KRISTIN SPIEDEL
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Credential |
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Telephone | 262-764-5891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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