Countryside Therapy Service LLC

Organization Physical Medicine & Rehabilitation Physician · NPI 1336391127

Countryside Therapy Service LLC is a Physical Medicine & Rehabilitation Physician in Waldo, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2008.

Licensed in: WI
In the registry since: 2008

What do these letters mean?

LLC — Limited liability company: A form of business registration, not a clinical qualification.

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Practice location Address checks out

W4523 County Road Iw
Waldo, WI 53093-1639
Phone: (920) 564-6107

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary)	Taxonomy 208100000X · Licence 5421-024 (WI)

Record details

NPI number	1336391127
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	John O'Dell — Owner · (920) 564-6107
NPI enumerated	October 13, 2008
Last updated in NPPES	October 13, 2008
Mailing address	Po Box 1127, Sheboygan, WI 53082-1127