NPI 1114393527
Supporting Provider Services
Practice location
- Address
- 8330 S Wynona CT, Oak Creek, WI 53154-2740
- Phone
- (262) 527-1282
Authorised official
- Name
- Theresa Buford
- Title
- Vocational Rehabilitation
- Phone
- (262) 527-1282
Registered specialties
Child Physical Disabilities Respite Care
Primary
Registry record
- NPI
- 1114393527
- Entity type
- Organization
- NPI issued
- 19 Aug 2015
- Record last updated
- 19 Aug 2015
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.