Eagle P-T

NPI #1811104193 in Greenfield, Wisconsin

Provider Information

NPI Number: 1811104193
Entity Type: Organization
Organization Name: Eagle P-T
Primary Specialty: Physical Therapist
Enumeration Date: May 17, 2007
Last Updated: Jun 20, 2008

Practice Location

Address: 3920 S 120TH ST
City: Greenfield
State: Wisconsin
ZIP Code: 53228-1882
Phone: (414) 546-2667

Authorized Official

Name: MR. DENNIS SOBUSH, PT
Title: OWNER
Phone: (414) 546-2667

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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