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General NPI Number Information
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NPI Number | 1285682385
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Entity Type | Organization
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Legal Business Name | SUSSEX FAMIILY PRACTICE PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | N64W24086 MAIN ST
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City | SUSSEX
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State | WI
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Zip | 53089-3002
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Country | US
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Telephone | 262-246-8009
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Fax | 262-246-4431
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Provider Business Mailing Address
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Address Line | PO BOX 127
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City | SUSSEX
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State | WI
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Zip | 53089-0127
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Country | US
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Telephone | 262-246-8009
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Fax | 262-246-4431
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JULIE KUHTZ
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Credential |
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Telephone | 262-246-8009
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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 |
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License Number State |
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