MEDICARE: UNITED THERAPY SERVICES, INC.

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
1	261QP2000X	Physical Therapy Clinic/Center	4806-024	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245238906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED THERAPY SERVICES, INC.

Provider Business Mailing Address
First Line	:	9729 W VIGO TER
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53227-3647
Country	:	US
Telephone Number	:	414-339-7871
Fax Number	:

Provider Business Practice Location Address
First Line	:	3209 S LAKE DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53235-3712
Country	:	US
Telephone Number	:	414-339-7871
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TIMOTHY P. RILEY
Credential	:	PT
Telephone Number	:	414-339-7871

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/22/2020

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Directions to “UNITED THERAPY SERVICES, INC. ” Practice Location

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