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General NPI Number Information
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NPI Number | 1154445690
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Entity Type | Organization
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Legal Business Name | THERAPY ADVANCES, INC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1010 N BIRD ST
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City | SUN PRAIRIE
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State | WI
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Zip | 53590-1174
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Country | US
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Telephone | 608-825-6637
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Fax | 608-825-6637
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Provider Business Mailing Address
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Address Line | 1010 N BIRD ST
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City | SUN PRAIRIE
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State | WI
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Zip | 53590-1174
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Country | US
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Telephone | 608-825-6637
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Fax | 608-825-6637
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Authorized Official
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Title or Position | OWNER
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Name | MATT KNUTSON
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Credential | P.T.
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Telephone | 608-825-6637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5858-024
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License Number State | WI
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