| Orthopedic & Spine Therapy Of Green Bay, Sc | |
|
301 N Broadway Ste 206, De Pere, WI 54115-2557 | |
| (920) 432-9040 | |
| (920) 432-9053 |
| Full Name | Orthopedic & Spine Therapy Of Green Bay, Sc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 301 N Broadway Ste 206, De Pere, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558477307 | NPI | - | NPPES |
| CI9565 | Other | WI | RAILROAD MEDICARE |
| 40415100 | Medicaid | WI | |
| 369376100 | Other | WI | US DEPARTMENT OF LABOR |
| 41745600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (Wisconsin) | Primary |
| Provider Name | Jill S Keil |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558474494 PECOS PAC ID: 4486642659 Enrollment ID: I20040505000846 |
| Provider Name | Paul S Barnett |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154368777 PECOS PAC ID: 6901701655 Enrollment ID: I20041026001048 |
| Provider Name | Jerome Gerard Charles |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225057912 PECOS PAC ID: 8628088549 Enrollment ID: I20060421000320 |
| Provider Name | Lisa A. Vivian |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285940098 PECOS PAC ID: 6800083007 Enrollment ID: I20101214001108 |
| Provider Name | Nicholas M Baudhuin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114282662 PECOS PAC ID: 6800045543 Enrollment ID: I20121012000447 |
| Provider Name | Matthew J Melotte |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528482684 PECOS PAC ID: 0143443176 Enrollment ID: I20140520002640 |
| Provider Name | Chase D Hanson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134672405 PECOS PAC ID: 4587952197 Enrollment ID: I20161014000980 |
| Provider Name | Bryanna R Blochowiak |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467029926 PECOS PAC ID: 4183025463 Enrollment ID: I20210623003615 |
| Provider Name | Jenna R Packer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902639610 PECOS PAC ID: 1153729157 Enrollment ID: I20211005003171 |
| Provider Name | Gregory J Mishica |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922545250 PECOS PAC ID: 0547659435 Enrollment ID: I20211115002543 |
| Mailing Address | Practice Location Address |
|---|---|
| Orthopedic & Spine Therapy Of Green Bay, Sc 4000 N. Providence Avenue, Appleton, WI 54913-8018 Ph: (920) 257-2000 | Orthopedic & Spine Therapy Of Green Bay, Sc 301 N Broadway Ste 206, De Pere, WI 54115-2557 Ph: (920) 432-9040 |
Jessica Ann Thorpe, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 555 Redbird Cir Ste 300, De Pere, WI 54115 Phone: 920-338-6870 | |
Orthopedic & Spine Therapy Of Green Bay Sc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3108 Mid Valley Dr, De Pere, WI 54115 Phone: 920-968-0814 Fax: 920-734-6159 | |
Charis N Carter, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 555 Redbird Cir, De Pere, WI 54115 Phone: 920-338-6870 Fax: 920-338-6829 | |
Mrs. Lauren E Kramer, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 S Ninth St, De Pere, WI 54115 Phone: 920-338-4146 | |
Dr. Joshua Vincent Egle, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700 | |
Katie Depeau, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 S 9th St, De Pere, WI 54115 Phone: 920-336-5680 | |
Emma Marie Louie, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1601 Lawrence Dr Ste 100, De Pere, WI 54115 Phone: 920-496-4700 |