Legacy Physiatry Group Wisconsin, LLC
NPI #1275914483 in Brookfield, Wisconsin
Provider Information
- NPI Number
- 1275914483
- Entity Type
- Organization
- Organization Name
- Legacy Physiatry Group Wisconsin, LLC
- Primary Specialty
- Physical Medicine & Rehabilitation
- Enumeration Date
- Jun 12, 2015
- Last Updated
- Jun 12, 2015
Practice Location
- Address
- 200 S EXECUTIVE DR
- Address 2
- SUITE 101
- City
- Brookfield
- State
- Wisconsin
- ZIP Code
- 53005-4216
- Phone
- (972) 372-1663
Authorized Official
- Name
- DR. VIVEK SASTRY, DO
- Title
- PRESIDENT/CEO
- Phone
- (972) 372-1663
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
| Internal Medicine - Cardiovascular Disease — Cardiovascular Disease |
| Internal Medicine - Pulmonary Disease — Pulmonary Disease |
| Physician Assistant |
| Nurse Practitioner |
| Physical Medicine & Rehabilitation |
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