Sport Clinic of Greater Milwaukee

NPI #1275628208 in Wauwatosa, Wisconsin

Provider Information

NPI Number: 1275628208
Entity Type: Organization
Organization Name: Sport Clinic of Greater Milwaukee
Primary Specialty: Physical Therapist
Enumeration Date: Oct 4, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 11904 W NORTH AVE
Address 2: STE 100
City: Wauwatosa
State: Wisconsin
ZIP Code: 53226-2062
Phone: (414) 453-8616

Authorized Official

Name: MR. MATTHEW BECKER
Title: C.F.O.
Phone: (414) 453-8616

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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