Wisconsin Center For Myofascial Release, Sc - Occupational Therapist in Kenosha, WI

Wisconsin Center For Myofascial Release, Sc is a Occupational Therapist based in Kenosha, Wisconsin. Wisconsin Center For Myofascial Release, Sc is licensed to practice in Wisconsin (license number 3534-026) and their current practice location is 4103 60th St, Kenosha, Wisconsin. It can be reached at their office (for appointments etc.) via phone at (262) 652-1111.

NPI number for Wisconsin Center For Myofascial Release, Sc is 1104042902 and their current mailing address is 4103 60th St, Kenosha, Wisconsin. Wisconsin Center For Myofascial Release, Sc does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1104042902.

Contact Information

Wisconsin Center For Myofascial Release, Sc
4103 60th St,
Kenosha, WI 53144-2509
(262) 652-1111
(262) 652-1124



Healthcare Provider's Profile

Full NameWisconsin Center For Myofascial Release, Sc
TypeFacility
SpecialityOccupational Therapist
Location4103 60th St, Kenosha, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1104042902
  • Provider Enumeration Date: 04/18/2007
  • Last Update Date: 08/26/2013

Medical Identifiers

Medical identifiers for Wisconsin Center For Myofascial Release, Sc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104042902NPI-NPPES
41012800MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 3534-026 (Wisconsin)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wisconsin Center For Myofascial Release, Sc is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Wisconsin Center For Myofascial Release, Sc
4103 60th St,
Kenosha, WI 53144-2509

Ph: (262) 652-1111
Wisconsin Center For Myofascial Release, Sc
4103 60th St,
Kenosha, WI 53144-2509

Ph: (262) 652-1111

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Occupational Therapist in Kenosha, WI

Richa Kamble,
Occupational Therapist
Medicare: Medicare Enrolled
Practice Location: 5060 Green Bay Rd, Kenosha, WI 53144
Phone: 262-825-0912    
Lacy Nowicki, OTR/L
Occupational Therapist
Medicare: Medicare Enrolled
Practice Location: 10222 74th St Ste 211, Kenosha, WI 53142
Phone: 262-925-5020    
Ana Jones, OTR
Occupational Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 1406 91st St Apt 103, Kenosha, WI 53143
Phone: 262-331-3414    
Ms. Jane E Meyers, OT
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 4103 60th St, Kenosha, WI 53144
Phone: 262-652-1111    Fax: 262-652-1124
Rachel Lauren Cole, OT
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 3100 Washington Rd, Kenosha, WI 53144
Phone: 248-930-4737    
Mrs. Silvana K Leone, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 6308 8th Ave, Kenosha, WI 53143
Phone: 262-656-3299    
Mrs. Jill Marie Fonk, MS, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 3100 Washington Rd, Kenosha, WI 53144
Phone: 262-658-4074    

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