West Bend Clinic, Inc.

NPI #1043220692 in West Bend, Wisconsin

Provider Information

NPI Number: 1043220692
Entity Type: Organization
Organization Name: West Bend Clinic, Inc.
Primary Specialty: Physical Therapist
Enumeration Date: Aug 8, 2006
Last Updated: May 23, 2012

Practice Location

Address: 1190 E PARADISE DR
City: West Bend
State: Wisconsin
ZIP Code: 53095-5444
Phone: (262) 306-6319

Authorized Official

Name: GREGORY G BLOMMEL
Title: ADMINISTRATOR
Phone: (262) 334-3451

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X
Surgery - Plastic and Reconstructive Surgery — Plastic and Reconstructive Surgery	2086S0122X
Occupational Therapy Assistant	224Z00000X
Physical Therapy Assistant	225200000X
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Durable Medical Equipment & Medical Supplies	332B00000X
Physical Therapist	225100000X	Primary

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