| Therapy Space LLC | |
|
740 Regent St Ste 202 Madison WI 53715-2649 | |
| (608) 572-2101 | |
| Not Available |
| Full Name | Therapy Space LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 740 Regent St Ste 202, Madison, Wisconsin |
| Authorized Official Name and Position | Brenda Lynn Heideman (CO-OWNER) |
| Authorized Official Contact | 6085722101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Space LLC 740 Regent St Ste 202 Madison WI 53715-2649 Ph: (608) 572-2101 | Therapy Space LLC 740 Regent St Ste 202 Madison WI 53715-2649 Ph: (608) 572-2101 |
| NPI Number | 1073105011 |
|---|---|
| Provider Enumeration Date | 02/10/2021 |
| Last Update Date | 02/10/2021 |
| Certification Date | 02/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073105011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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