ADVANTAGE PHYSICAL THERAPY & SPORTS REHAB LLC NPI 1366013278

NPI Information

NPI: 1366013278
Provider Name: ADVANTAGE PHYSICAL THERAPY & SPORTS REHAB, LLC

Doing Business As: CORA PHYSICAL THERAPY - KENOSHA NORTH

Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
3620 57TH AVE STE 400
KENOSHA, WI
ZIP 53144
Phone: (262) 925-5250
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ADVANTAGE PHYSICAL THERAPY & SPORTS REHAB, LLC is a rehabilitation clinic center in Kenosha, WI. ADVANTAGE PHYSICAL THERAPY & SPORTS REHAB, LLC NPI is 1366013278. The provider is registered as an organization entity type.
The provider Is Doing Business As Cora Physical Therapy - Kenosha North.

The provider's business location address is:

3620 57TH AVE STE 400
KENOSHA, WI
ZIP 53144-925
Phone: (262) 925-5250
Fax: (262) 925-5251

The provider's authorized official is Stephen Krzyminski .
The authorized official title is Executive Vice President and has the following contact phone number (419) 221-6717.

The enumeration date for this NPI number is 7/2/2021 and was last updated on 2/27/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100217837	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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