# LIFESPEED PHYSICAL THERAPY AND FITNESS

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

## Provider details

- **NPI number:** 1366535742
- **Authorized official:** MR. LARRY D BRIAND (CO-OWNER)
- **Authorized official phone:** (877) 552-2996

## Contact information

- **Practice address:** N64W24678 MAIN ST, SUITE B, SUSSEX, WI 53089
- **Practice address phone:** (262) 820-2686
- **Practice address fax:** (866) 245-8064
- **Mailing address:** 8700 DURAND AVE, SUITE D, STURTEVANT, WI 53177
- **Mailing address phone:** (877) 552-2996
- **Mailing address fax:** (866) 245-8064

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 6020-024 | WI | Yes |

## Other

- **Enumeration date:** 09/30/2006
- **Last updated:** 08/22/2020