# KEYSTONE PHYSICAL THERAPY LLC

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** KRC Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427196765
- **Authorized official:** AMY CARLSON (BUSINESS MANAGER)
- **Authorized official phone:** (262) 790-5775

## Contact information

- **Practice address:** 19265 W CAPITOL DR STE L01, BROOKFIELD, WI 53045-2740
- **Practice address phone:** (262) 790-5775
- **Practice address fax:** (262) 790-5710
- **Mailing address:** 19265 W CAPITOL DR STE L01, BROOKFIELD, WI 53045-2740
- **Mailing address phone:** (262) 790-5775
- **Mailing address fax:** (262) 790-5710

## Taxonomy

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

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 08/05/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 392031168010 | ANTHEM BCBS | — |