# LAKES AREA PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1588845804
- **Authorized official:** JOHN R VAN SUSTEREN (PHYSICAL THERAPIS / OWNER)
- **Authorized official phone:** (262) 248-9902

## Contact information

- **Practice address:** 800 GENEVA PKWY N, SUITE 3, LAKE GENEVA, WI 53147-5701
- **Practice address phone:** (262) 248-9902
- **Practice address fax:** (262) 248-9419
- **Mailing address:** 800 GENEVA PKWY N, SUITE 3, LAKE GENEVA, WI 53147-5701
- **Mailing address phone:** (262) 248-9902
- **Mailing address fax:** (262) 248-9419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 4467024 | WI | Yes |

## Other

- **Enumeration date:** 11/15/2007
- **Last updated:** 04/07/2010