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General NPI Number Information
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NPI Number | 1861698177
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Entity Type | Organization
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Legal Business Name | DYNAMICS OF FUNCTION, LTD
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Dates
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Enumeration Date | 06/23/2007
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 7441 S 27TH ST SUITE 204
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City | FRANKLIN
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State | WI
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Zip | 53132-9383
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Country | US
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Telephone | 414-764-2871
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Fax | 414-764-6475
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Provider Business Mailing Address
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Address Line | 7441 S 27TH ST SUITE 204
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City | FRANKLIN
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State | WI
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Zip | 53132-9383
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Country | US
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Telephone | 414-764-2871
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Fax | 414-764-6475
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Authorized Official
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Title or Position | OWNER
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Name | SABRINA D EDER
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Credential | MPT
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Telephone | 414-764-2871
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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 | 6286024
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License Number State | WI
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