Sport & Spine Clinic of Fort Atkinson Limited Partnership

NPI #1184812612 in Edgerton, Wisconsin

Provider Information

NPI Number: 1184812612
Entity Type: Organization
Organization Name: Sport & Spine Clinic of Fort Atkinson Limited Partnership
Primary Specialty: Clinic/Center - Physical Therapy
Enumeration Date: Oct 10, 2007
Last Updated: Jun 16, 2008

Practice Location

Address: 119 HENRY STREET
City: Edgerton
State: Wisconsin
ZIP Code: 53534
Phone: (608) 884-8514

Authorized Official

Name: JANNA P. KING, JD
Title: VP, AUTHORIZED OFFICIAL
Phone: (713) 297-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Physical Therapy — Physical Therapy	261QP2000X	Primary

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