MEDICARE: RIVERVIEW PHYSICAL THERAPY & SPORTS MEDICINE ,S.C.

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	225100000X	Physical Therapist	6535-024	WI
2	225100000X	Physical Therapist	4345-024	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	:	1922180918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERVIEW PHYSICAL THERAPY & SPORTS MEDICINE ,S.C.

Provider Business Mailing Address
First Line	:	516 E GREEN BAY AVE
Second Line	:
City	:	SAUKVILLE
State	:	WI
Zip	:	53080-2012
Country	:	US
Telephone Number	:	262-284-9510
Fax Number	:	262-284-9511

Provider Business Practice Location Address
First Line	:	516 E GREEN BAY AVE
Second Line	:
City	:	SAUKVILLE
State	:	WI
Zip	:	53080-2012
Country	:	US
Telephone Number	:	262-284-9510
Fax Number	:	262-284-9511

Authorized Official
Title or Position	:	PRESIDENT/PHYSICAL THERAPIST
Name	:	DIANE MARY OTT
Credential	:	PT
Telephone Number	:	262-284-9510

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1326681479 — KELLY THOMPSON
Practice Location Address:

534 E GREEN BAY AVE
SAUKVILLE, WI
53080-2012

Practice Phone: 262-388-3700
Practice Fax:

1487491205 — RIVERSIDE PHYSICAL THERAPY & PELVIC HEALTH, S.C.
Practice Location Address:

516 E GREEN BAY AVE
SAUKVILLE, WI
53080-2012

Practice Phone: 262-284-9510
Practice Fax: 262-284-9511

1710931373 — VILLAGE OF SAUKVILLE
Practice Location Address:

520 W DEKORA ST
SAUKVILLE, WI
53080-1619

Practice Phone: 262-284-5800
Practice Fax: 262-284-0775

1457378507 — WAL-MART STORES EAST LP
Practice Location Address:

825 E GREEN BAY AVE
SAUKVILLE, WI
53080-2618

Practice Phone: 262-284-9881
Practice Fax:

1932127321 — DEE ANN M SMITH MD
Practice Location Address:

830 E GREEN BAY AVE STE 100
SAUKVILLE, WI
53080-2662

Practice Phone: 262-284-7117
Practice Fax:

1649294257 — ANTISDEL DENTAL CLINIC, S.C.
Practice Location Address:

661 E GREEN BAY AVE
SAUKVILLE, WI
53080-2013

Practice Phone: 262-284-7111
Practice Fax: 262-284-1172

Directions to “RIVERVIEW PHYSICAL THERAPY & SPORTS MEDICINE ,S.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.