MEDICARE: ACTRA REHABILITATION ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831164706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTRA REHABILITATION ASSOCIATES INC

Provider Business Mailing Address
First Line	:	2727 W CLEVELAND AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-2908
Country	:	US
Telephone Number	:	414-647-8828
Fax Number	:	414-647-8878

Provider Business Practice Location Address
First Line	:	2727 W CLEVELAND AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-2908
Country	:	US
Telephone Number	:	414-647-8828
Fax Number	:	414-647-8878

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	RICHARD S BINSTEIN
Credential	:
Telephone Number	:	610-644-7824

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	06/16/2009

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