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Organization
SPORTS PHYSICAL THERAPISTS OF RACINE LLC
Active
Organization
SPORTS PHYSICAL THERAPISTS OF RACINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMELO D TENUTA PT (PRESIDENT / CEO)
(262) 925-5000
Entity
Organization
Contact information
Practice address
7200 WASHINGTON AVE, STE D103, MOUNT PLEASANT, WI 53406-6516
(262) 583-0790
(262) 583-0768
Mailing address
3921 30TH AVE STE C, KENOSHA, WI 53144-1957
(262) 925-5004
(262) 925-5001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
03/16/2017
Last updated
06/05/2020
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