Healthcare Provider Details

I. General information

NPI: 1629411202
Provider Name (Legal Business Name): PHYSICAL THERAPY OF MILWAUKEE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 09/28/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3906 S 27TH ST
MILWAUKEE WI
53221-1826
US

IV. Provider business mailing address

3906 S 27TH ST
MILWAUKEE WI
53221-1826
US

V. Phone/Fax

Practice location:
  • Phone: 414-702-4678
  • Fax: 414-423-4134
Mailing address:
  • Phone: 414-281-3444
  • Fax: 414-281-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateWI

VIII. Authorized Official

Name: SYLVESTRA RAMIREZ
Title or Position: OWNER
Credential: PT, DPT, MWH, CEAS
Phone: 414-702-4678