# BADGER STATE THERAPY ASSOCIATES

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

## Provider details

- **NPI number:** 1265609069
- **Authorized official:** MS. SUSAN JOY ADRIANSEN (PT PARTNER)
- **Authorized official phone:** (414) 332-1511

## Contact information

- **Practice address:** 2611 NORTH LAKE DRIVE, MILWAUKEE, WI 53211
- **Practice address phone:** (414) 332-1511
- **Mailing address:** 2611 NORTH LAKE DRIVE, MILWAUKEE, WI 53211
- **Mailing address phone:** (414) 332-1511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 05/12/2008
- **Last updated:** 05/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41202800 | — | WI |