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General NPI Number Information
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NPI Number | 1952724304
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC HEALING, LLC
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 05/13/2014
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Provider Practice Location Address
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Address Line | S77 W30705 MOSHER DR.
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City | MUKWONAGO
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State | WI
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Zip | 53149
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Country | US
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Telephone | 262-470-2512
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Fax |
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Provider Business Mailing Address
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Address Line | S77W30705 MOSHER DR.
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City | MUKWONAGO
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State | WI
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Zip | 53149
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Country | US
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Telephone | 262-470-2512
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JANETTE MARIE PILLING
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Credential | OT
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Telephone | 262-470-2512
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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 | 273-26
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License Number State | WI
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