| Organization Name: | SPINE & ORTHOPEDIC PHYSICAL THERAPY |
| NPI Number: | 1205954369 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | OLALEKAN LUKMAN GANIYU (OWNER OF PRACTICE AND P.T.) |
| Mailing Address: | 2958 Prairie Ave Ste B Beloit |
| State: | WI US |
| Postal Code: | 535111825 |
| Phone Number: | 6083689783 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5648-024 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |