Provider Demographics
NPI:1912715970
Name:NORTHWOODS SPORT & HAND, INC
Entity type:Organization
Organization Name:NORTHWOODS SPORT & HAND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-839-9266
Mailing Address - Street 1:1200 OAKLEAF WAY STE B
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-2217
Mailing Address - Country:US
Mailing Address - Phone:715-839-9266
Mailing Address - Fax:
Practice Address - Street 1:400 W 9TH ST N STE 4
Practice Address - Street 2:
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-1264
Practice Address - Country:US
Practice Address - Phone:715-839-9266
Practice Address - Fax:715-839-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy