Five Corners Physical Therapy S.C.
LBN: Five Corners Physical Therapy S.C.
Five Corners Physical Therapy S.C. is an health care organization with primary practice located at 7269 State Road 60 Suite 1, Cedarburg WI 53012-9702. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is the primary health care specialty.
Five Corners Physical Therapy S.C. can be contacted via phone (262) 377-8350, or through Provencher, Timothy John via phone (262) 377-8350.
Contact Information
Primary practice address
7269 State Road 60 Suite 1
Cedarburg WI 53012-9702
Phone: (262) 377-8350
Fax: (262) 377-8390
Website:
Authorized official contact:
Name: Provencher, Timothy John Physical Therapist (PT)
Phone: (262) 377-8350
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 4146-024 | Wisconsin |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 1504-154 | Wisconsin |
Profile Details
| NPI number | 1427195304 |
|---|---|
| LBN Legal business name | Five Corners Physical Therapy S.C. |
| DBA Doing business as | |
| Authorized official | Provencher, Timothy John Physical Therapist (PT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Aug 22nd, 2020 - about 6 years ago |
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 | 1427195304 | NPPES |
| Wisconsin | MEDICAID | 40302100 |
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