Impact Physical Therapy & Performance Llc

LBN: Impact Physical Therapy & Performance Llc
Impact Physical Therapy & Performance Llc is an health care organization with primary practice located at 1155 Clarity Dr , Verona WI 53593-9318. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Impact Physical Therapy & Performance Llc can be contacted via phone (608) 293-4508, or through Koester, Matthew via phone (608) 293-4508.

Contact Information

Primary practice address
1155 Clarity Dr Verona WI 53593-9318
Phone: (608) 293-4508
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Koester, Matthew PT, DPT
Phone: (608) 293-4508

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X

Profile Details

NPI number 1821649088
LBN Legal business name Impact Physical Therapy & Performance Llc
DBA Doing business as
Authorized official Koester, Matthew PT, DPT
Entity Organization
Organization subpart 1 No
Enumeration date Sep 27th, 2019
Last updated Sep 27th, 2019 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821649088 NPPES
Wisconsin MEDICAID 1245889229

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