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NPI Code Detail

MEDICARE: CONCIERGE REHAB GROUP LLC

MEDICARE: CONCIERGE REHAB GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1033795174
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONCIERGE REHAB GROUP LLC
Provider Business Mailing Address
First Line : 302 S 4TH ST
Second Line :
City : MOUNT HOREB
State : WI
Zip : 53572-2220
Country : US
Telephone Number : 224-216-3518
Fax Number :
Provider Business Practice Location Address
First Line : 525 JUNCTION RD STE 6500
Second Line :
City : MADISON
State : WI
Zip : 53717-2153
Country : US
Telephone Number : 224-216-3518
Fax Number : 312-500-4687
Authorized Official
Title or Position : MANAGING MEMBER
Name : MR. JEFFREY J MATHIS
Credential :
Telephone Number : 224-216-3518
Provider Enumeration Date : 03/19/2021
Last Update Date : 03/19/2021

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Directions to “CONCIERGE REHAB GROUP LLC ” Practice Location

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