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Organization
PHYSICAL ACHIEVEMENT CENTER LLC
Active
Organization
PHYSICAL ACHIEVEMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC LEO KOEHLER PT, DPT, OCS (OWNER)
(920) 379-9692
Entity
Organization
Contact information
Practice address
3475 OMRO RD STE 300, OSHKOSH, WI 54904
(920) 230-2747
(920) 385-7074
Mailing address
3475 OMRO RD STE 300, OSHKOSH, WI 54904-7126
(920) 230-2747
(920) 385-7074
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4017-024
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40187000
—
WI
Enumeration date
07/13/2017
Last updated
07/21/2022
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