Advantage Physical Therapy & Sports Rehab, LLC
Clinic/Center, Rehabilitation in Pleasant Prairie, WI. Organization (NPI-2).
NPI number1104497015
StatusActive
Last updated in NPPESFeb 27, 2024
Details
- NPI
- 1104497015
- Entity type
- Organization (NPI-2)
- Legal business name
- Advantage Physical Therapy & Sports Rehab, LLC
- Organization subpart
- No
- Enumeration date
- Jul 2, 2021
- Certification date
- Feb 27, 2024
- Last updated
- Feb 27, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0400X | Clinic/Center, Rehabilitation | – | – | Yes |
Other names
- Cora Physical Therapy - Pleasant Prairie (Doing Business As)
Practice location
9809 39th Ave Ste 2Pleasant Prairie, WI 53158-3733
Phone 262-925-5080 · Fax 262-925-5081
Mailing address
Po Box 150Lima, OH 45802-0150
Phone 419-221-6717 · Fax 419-222-0507
Authorized official
Steve Krzyminski
Exec. Vp
4192216717
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