Organization Name: | WEBER PHYSICAL THERAPY, LLC |
NPI Number: | 1386011682 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KYLE WEBER (OWNER) |
Mailing Address: | 13445 Tosca Ct Elm Grove |
State: | WI US |
Postal Code: | 531221343 |
Phone Number: | 6122205361 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2015 |
NPI Last Update Date: | 08/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 12288-24 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |