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General NPI Number Information
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NPI Number | 1386261659
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Entity Type | Organization
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Legal Business Name | SPS INTEGRATED THERAPIES, LLC
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 829 W CLAIREMONT AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6102
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Country | US
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Telephone | 715-833-3505
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Fax | 715-833-8515
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Provider Business Mailing Address
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Address Line | 829 W CLAIREMONT AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6102
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Country | US
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Telephone | 715-833-3505
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Fax | 715-833-8515
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA PRISSEL
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Credential | DC
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Telephone | 715-833-3505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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