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Organization
ADVANCED PHYSICAL THERAPY & SPORTS MEDICINE SC
Active
Organization
ADVANCED PHYSICAL THERAPY & SPORTS MEDICINE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLA MEYER (CREDENTIALING SPECIALIST)
(920) 393-2819
Entity
Organization
Contact information
Practice address
2105 E ENTERPRISE AVE # 113, ADVANCED PHYSICAL THERAPY, APPLETON, WI 54913-7862
(920) 991-2561
(920) 991-2563
Mailing address
2105 E ENTERPRISE AVE STE 113, APPLETON, WI 54913-7862
(920) 991-2561
(920) 991-2563
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
08/09/2005
Last updated
03/10/2026
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