| Jensen Interhealth | |
|
233 Carroll St, Random Lake, WI 53075 | |
| (920) 994-4515 | |
| (920) 994-4583 |
| Full Name | Jensen Interhealth |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 233 Carroll St, Random Lake, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316978893 | NPI | - | NPPES |
| 3728-024 | Other | WI | LISCENSE |
| 40428700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 3728-24 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jensen Interhealth W8093 County A, Adell, WI 53001-1462 Ph: (920) 994-4515 | Jensen Interhealth 233 Carroll St, Random Lake, WI 53075 Ph: (920) 994-4515 |
Richard Polk, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: N546 Schroeter Dr, Random Lake, WI 53075 Phone: 920-207-3550 Fax: 920-994-4606 | |
Mrs. Marlena Elizabeth Salazar, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N546 Schroeter Dr, Random Lake, WI 53075 Phone: 920-207-3550 Fax: 920-994-8466 | |
Abby Lynn Risse, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 402 1st St, Random Lake, WI 53075 Phone: 920-994-9700 Fax: 920-994-4606 | |
Mrs. Julie M. Schmitt, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N546 Schroeter Dr, Random Lake, WI 53075 Phone: 920-994-9700 | |
Michelle M Grace-jensen, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 233 Carroll St, Random Lake, WI 53075 Phone: 920-912-0058 | |
Ms. Virginia K Bowen, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 402 First Street, Random Lake, WI 53075 Phone: 920-994-9700 Fax: 920-994-4606 |