OrganizationInnersparks,LlcOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1468 N High Point Rd, Middleton, WI 53562-3683(608) 836-0305(608) 516-7087PECOS EnrollmentBased on the most recent information from CMS, provider Innersparks,Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1053942110Provider TypeOrganizationFull NameInnersparks,LlcSubpartNoEnumeration Date1/28/2020Last Updated1/28/2020Contact InformationPractice LocationPractice Address1468 N High Point Rd, Middleton, WI 53562-3683Phone(608) 836-0305FaxUnlisted FaxMailing LocationMailing Address6310 Stonefield Rd, Middleton, WI 53562-3839Phone(608) 516-7087FaxUnlisted FaxAuthorized OfficialNameKivolowitz, Andrea (Owner)Phone(608) 836-0305Provider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID26-1173DescriptionOtherIssuerSTATE LICENSEWisconsin