Sports Physical Therapy & Rehab Specialist, S.c.

NPI #1891295614 in Brookfield, Wisconsin

Provider Information

NPI Number: 1891295614
Entity Type: Organization
Organization Name: Sports Physical Therapy & Rehab Specialist, S.c.
Primary Specialty: Clinic/Center
Enumeration Date: Feb 19, 2018
Last Updated: Feb 19, 2018

Practice Location

Address: 17495 W CAPITOL DR STE L
City: Brookfield
State: Wisconsin
ZIP Code: 53045-2059
Phone: (262) 879-0010

Authorized Official

Name: JUANA GRANADOS
Title: CREDENTIALING MANAGER
Phone: (630) 575-1980

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X
Occupational Therapist	225X00000X
Clinic/Center	261Q00000X	Primary

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