# FREEDOM PHYSICAL THERAPY SERVICES SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063406544
- **Authorized official:** MR. PETER J STATHAS PT (PRESIDENT)
- **Authorized official phone:** (414) 352-2082

## Contact information

- **Practice address:** 6908 N SANTA MONICA BLVD, FOX POINT, WI 53217-3942
- **Practice address phone:** (414) 352-2082
- **Practice address fax:** (414) 352-5279
- **Mailing address:** 6908 N SANTA MONICA BLVD, FOX POINT, WI 53217-3942
- **Mailing address phone:** (414) 352-2082
- **Mailing address fax:** (414) 352-5279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | WI | Yes |

## Other

- **Enumeration date:** 09/09/2005
- **Last updated:** 10/05/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 40418500 | — | WI |