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Organization
ADVANTAGE PT & SPORTS REHAB LLC
Active
Organization
ADVANTAGE PT & SPORTS REHAB LLC
Active
Other names
CORA Physical Therapy - Kenosha Midtown
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE KRZYMINSKI (EXEC VP)
(419) 221-6717
Entity
Organization
Contact information
Practice address
5024 GREEN BAY RD, KENOSHA, WI 53144-1702
(419) 221-6717
(419) 222-0507
Mailing address
PO BOX 150, LIMA, OH 45802-0150
(419) 221-6717
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100192499
—
WI
Enumeration date
01/05/2022
Last updated
02/27/2024
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