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General NPI Number Information
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NPI Number | 1780934638
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Entity Type | Organization
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Legal Business Name | WISCONSIN INTEGRATIVE HYPERBARIC CENTER
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 6200 NESBITT RD STE B
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City | FITCHBURG
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State | WI
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Zip | 53719-1949
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Country | US
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Telephone | 608-278-4268
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Fax | 608-278-4260
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Provider Business Mailing Address
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Address Line | 6200 NESBITT RD STE B
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City | FITCHBURG
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State | WI
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Zip | 53719-1949
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Country | US
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Telephone | 608-278-4268
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Fax | 608-278-4260
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. SHANNON M KENITZ
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Credential |
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Telephone | 608-278-4268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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