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General NPI Number Information
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NPI Number | 1356463087
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Entity Type | Organization
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Legal Business Name | OPTIMUM THERAPIES, LLC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 1309 STOUT RD
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City | MENOMONIE
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State | WI
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Zip | 54751-2959
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Country | US
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Telephone | 715-233-6230
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Fax | 715-233-6231
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Provider Business Mailing Address
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Address Line | 1309 STOUT RD
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City | MENOMONIE
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State | WI
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Zip | 54751-2959
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Country | US
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Telephone | 715-233-6230
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Fax | 715-233-6231
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | JODI DRESEN
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Credential |
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Telephone | 715-607-1758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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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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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 5270-024
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License Number State | WI
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