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General NPI Number Information
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NPI Number | 1578325726
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Entity Type | Organization
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Legal Business Name | LEVERAGE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 1907 13 1/2 AVE
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City | CAMERON
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State | WI
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Zip | 54822-9588
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Country | US
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Telephone | 262-689-2018
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 13 1/2 AVE
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City | CAMERON
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State | WI
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Zip | 54822-9588
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | BRETT N SCOLES
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Credential |
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Telephone | 262-689-2018
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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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