| Organization Name: | MIRACLE PHYSICAL THERAPY AND REHAB SPECIALISTS LLC |
| NPI Number: | 1679742191 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LARRY BRIAND (OWNER) |
| Mailing Address: | 2333 W Ryan Rd Oak Creek |
| State: | WI US |
| Postal Code: | 531544322 |
| Phone Number: | 8775522996 |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2008 |
| NPI Last Update Date: | 05/18/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 4072024 |
| 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 |