Provider Demographics
NPI:1386261659
Name:SPS INTEGRATED THERAPIES, LLC
Entity type:Organization
Organization Name:SPS INTEGRATED THERAPIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-833-3505
Mailing Address - Street 1:829 W CLAIREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6102
Mailing Address - Country:US
Mailing Address - Phone:715-833-3505
Mailing Address - Fax:715-833-8515
Practice Address - Street 1:829 W CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6102
Practice Address - Country:US
Practice Address - Phone:715-833-3505
Practice Address - Fax:715-833-8515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty