Fastback Physical Therapy LLC
NPI #1104393982 in New Berlin, Wisconsin
Provider Information
- NPI Number
- 1104393982
- Entity Type
- Organization
- Organization Name
- Fastback Physical Therapy LLC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Oct 30, 2018
- Last Updated
- Aug 6, 2024
Practice Location
- Address
- 3333 S SUNNYSLOPE RD STE 103B
- City
- New Berlin
- State
- Wisconsin
- ZIP Code
- 53151-4504
- Phone
- (262) 853-8452
Authorized Official
- Name
- MICHELE WENINGER
- Title
- CREDENTIALING SPECIALIST
- Phone
- (248) 601-9207
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
| Physical Therapist |
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