Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wisconsin Center for Myofascial Release, SC

Organization Occupational Therapist · NPI 1104042902

Wisconsin Center for Myofascial Release, SC is an Occupational Therapist in Kenosha, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.

Licensed in
WI
In the registry since
2007

Practice location Address checks out

4103 60th St
Kenosha, WI 53144-2509
Phone: (262) 652-1111
Fax: (262) 652-1124
Show map & directions

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

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 3534-026 (WI)

Record details

NPI number1104042902
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Priscilla Horswell — Office Manager · (262) 652-1111
NPI enumeratedApril 18, 2007
Last updated in NPPESAugust 26, 2013
Mailing address4103 60th St, Kenosha, WI 53144-2509

Other providers in Kenosha