Advanced Spine and Sport
NPI #1033277553 in Mount Pleasant, Wisconsin
Provider Information
- NPI Number
- 1033277553
- Entity Type
- Organization
- Organization Name
- Advanced Spine and Sport
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Dec 5, 2006
- Last Updated
- Jan 13, 2024
Practice Location
- Address
- 6222 WASHINGTON AVE
- City
- Mount Pleasant
- State
- Wisconsin
- ZIP Code
- 53406-3948
- Phone
- (262) 884-6418
Authorized Official
- Name
- THOMAS D VAN DE WATER, MPT
- Title
- MANAGING PARTNER
- Phone
- (262) 884-6418
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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