Great Lakes Physical Therapy, LLC

NPI #1124105028 in Sheboygan, Wisconsin

Provider Information

NPI Number: 1124105028
Entity Type: Organization
Organization Name: Great Lakes Physical Therapy, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 1, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 3303 SUPERIOR AVE
City: Sheboygan
State: Wisconsin
ZIP Code: 53081-1861
Phone: (920) 208-3557

Authorized Official

Name: MR. JOE E MOORE, P.T
Title: OWNER
Phone: (920) 208-3557

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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