Body & Soul Mfr Therapy LLC

NPI #1376287896 in Green Bay, Wisconsin

Provider Information

NPI Number: 1376287896
Entity Type: Organization
Organization Name: Body & Soul Mfr Therapy LLC
Subpart: Yes (part of a larger organization)
Parent Organization: BODY & SOUL MFR THERAPY LLC
Primary Specialty: Occupational Therapist
Enumeration Date: Apr 21, 2022
Last Updated: Jan 2, 2024

Practice Location

Address: 110 PACKERLAND DR STE C2
City: Green Bay
State: Wisconsin
ZIP Code: 54303-4861
Phone: (920) 209-0012

Authorized Official

Name: YVONNE VANDER HEIDEN, COTA
Title: OWNER
Phone: (920) 209-0012

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapy Assistant	224Z00000X
Occupational Therapist	225X00000X	Primary

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