Speckbrock, Pamela Sue

Speckbrock, Pamela Sue is an individual health care provider with primary practice located at 901 Mulberry St , Lake Mills WI 53551-1335. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Driving and Community Mobility, which is considered as her primary health care specialty. Speckbrock, Pamela Sue can be contacted via phone (920) 648-8344.

Contact Information

Primary practice address
901 Mulberry St Lake Mills WI 53551-1335
Phone: (920) 648-8344
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Driving and Community Mobility 225XR0403X 3103026 Wisconsin

Profile Details

NPI number 1750502035
LBN Legal business name Speckbrock, Pamela Sue
Credentials Registered Occupational Therapist (OTR)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750502035 NPPES
Wisconsin MEDICAID 40853500

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