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General NPI Number Information
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NPI Number | 1912063868
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Entity Type | Organization
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Legal Business Name | MILESTONES PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3670 ISAACSON RD
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City | SCANDINAVIA
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State | WI
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Zip | 54977-9604
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Country | US
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Telephone | 715-252-1598
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Fax | 715-824-2350
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Provider Business Mailing Address
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Address Line | 3670 ISAACSON RD
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City | SCANDINAVIA
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State | WI
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Zip | 54977-9604
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Country | US
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Telephone | 715-252-1598
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Fax | 715-824-2350
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, MEMBER
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Name | PATRICIA ANNE ORTHWEIN
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Credential | P.T.
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Telephone | 715-252-1598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3515024
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License Number State | WI
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