Provider Demographics
NPI:1174557425
Name:RETURN TO WORK & SPORTS CENTER, INC
Entity type:Organization
Organization Name:RETURN TO WORK & SPORTS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:V
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-570-0441
Mailing Address - Street 1:8825 S HOWELL AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-3760
Mailing Address - Country:US
Mailing Address - Phone:414-570-0441
Mailing Address - Fax:414-570-0442
Practice Address - Street 1:8825 S HOWELL AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-3760
Practice Address - Country:US
Practice Address - Phone:414-570-0441
Practice Address - Fax:414-570-0442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41814100Medicaid
WI41814100Medicaid