MEDICARE: PRIME TRAINING, LLC

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

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	:	1750846895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME TRAINING, LLC

Provider Business Mailing Address
First Line	:	1261 ELSIE ST
Second Line	:
City	:	FORT ATKINSON
State	:	WI
Zip	:	53538-1514
Country	:	US
Telephone Number	:	608-201-0641
Fax Number	:

Provider Business Practice Location Address
First Line	:	1261 ELSIE ST
Second Line	:
City	:	FORT ATKINSON
State	:	WI
Zip	:	53538-1514
Country	:	US
Telephone Number	:	608-201-0641
Fax Number	:	262-458-2999

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KURT CHAPMAN
Credential	:	DPT
Telephone Number	:	608-201-0641

Provider Enumeration Date	:	02/03/2019
Last Update Date	:	11/11/2024

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