OrganizationActive
Wisconsin Center for Myofascial Release, Sc
NPI 1104042902 · Occupational Therapist · Kenosha, WI
Provider details
- NPI number
- 1104042902
- Entity type
- Organization
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Priscilla Horswell, Office Manager(262) 652-1111
- License
- 3534-026 (WI)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4103 60th St
Kenosha, WI 53144-2509
Phone: (262) 652-1111
Fax: (262) 652-1124
Street-level locationGet directions
Mailing address
4103 60th St
Kenosha, WI 53144-2509
Registry dates
- Enumerated
- 2007-04-18
- Last updated
- 2013-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.