Advanced Spine And Sport Rehabilitation
LBN: Advanced Spine And Sport
Advanced Spine And Sport Rehabilitation is an health care organization with primary practice located at 6222 Washington Ave , Mount Pleasant WI 53406-3948. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty.
Advanced Spine And Sport can be contacted via phone (262) 884-6418, or through Van De Water, Thomas D via phone (262) 884-6418.
Contact Information
Primary practice address
6222 Washington Ave
Mount Pleasant WI 53406-3948
Phone: (262) 884-6418
Fax: (262) 884-6489
Website:
Authorized official contact:
Name: Van De Water, Thomas D Master of Physical Therapy (MPT)
Phone: (262) 884-6418
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X |
Profile Details
| NPI number | 1033277553 |
|---|---|
| LBN Legal business name | Advanced Spine And Sport |
| DBA Doing business as | Advanced Spine And Sport Rehabilitation |
| Authorized official | Van De Water, Thomas D Master of Physical Therapy (MPT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 5th, 2006 |
| Last updated | Jan 13th, 2024 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033277553 | NPPES |
| Wisconsin | MEDICAID | 40427900 |
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