Provider Demographics
NPI:1073506622
Name:MONONA REHABILITATION SERVICES INC
Entity type:Organization
Organization Name:MONONA REHABILITATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:RM
Authorized Official - Last Name:KUNZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-222-2325
Mailing Address - Street 1:PO BOX 6157
Mailing Address - Street 2:MONONA REHABILITATION SERVICES
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716-0157
Mailing Address - Country:US
Mailing Address - Phone:608-222-2325
Mailing Address - Fax:608-222-3823
Practice Address - Street 1:4100 MONONA DR
Practice Address - Street 2:MONONA REHABILITATION SERVICES
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53716-1674
Practice Address - Country:US
Practice Address - Phone:608-222-2325
Practice Address - Fax:608-222-3823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2804024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q23338Medicare UPIN