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Organization
ORTHOPEDIC & SPORTS THERAPY SC
Active
Organization
ORTHOPEDIC & SPORTS THERAPY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD ALAN MAYER PT (OWNER)
(262) 549-1118
Entity
Organization
Contact information
Practice address
S22W22660 BROADWAY, #3A, WAUKESHA, WI 53186-8100
(262) 549-1118
(262) 549-1118
Mailing address
S22W22660 BROADWAY, #3A, WAUKESHA, WI 53186-8100
(262) 549-1118
(262) 549-1118
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40023900
—
WI
Enumeration date
04/16/2008
Last updated
04/16/2008
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