Great Lakes Physical Therapy, Llc
LBN: Great Lakes Physical Therapy, Llc
Great Lakes Physical Therapy, Llc is an health care organization with primary practice located at 3303 Superior Ave , Sheboygan WI 53081-1861. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty.
Great Lakes Physical Therapy, Llc can be contacted via phone (920) 208-3557, or through Moore, Joe E via phone (920) 208-3557.
Contact Information
Primary practice address
3303 Superior Ave
Sheboygan WI 53081-1861
Phone: (920) 208-3557
Fax: (920) 208-3527
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X |
Profile Details
| NPI number | 1124105028 |
|---|---|
| LBN Legal business name | Great Lakes Physical Therapy, Llc |
| DBA Doing business as | |
| Authorized official | Moore, Joe E Physical Therapist (PT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Aug 22nd, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124105028 | NPPES |
| Wisconsin | MEDICAID | 40420500 | |
| Wisconsin | Other | 7725040 |
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