Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
FIVE CORNERS PHYSICAL THERAPY S.C.
Active
Organization
FIVE CORNERS PHYSICAL THERAPY S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY JOHN PROVENCHER PT (PRESIDENT)
(262) 377-8350
Entity
Organization
Contact information
Practice address
7269 STATE ROAD 60, SUITE 1, CEDARBURG, WI 53012-9702
(262) 377-8350
(262) 377-8390
Mailing address
7269 STATE ROAD 60, SUITE 1, CEDARBURG, WI 53012-9702
(262) 377-8350
(262) 377-8390
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4146-024
WI
235Z00000X
Speech-Language Pathologist
Primary
1504-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40302100
—
WI
Enumeration date
01/31/2007
Last updated
09/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers