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Organization
VICTORY PHYSICAL THERAPY AND WELLNESS SPECIALISTS
Active
Organization
VICTORY PHYSICAL THERAPY AND WELLNESS SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY BRIAND PT, ATC (CO-OWNER)
(877) 552-2996
Entity
Organization
Contact information
Practice address
3908 HALL AVE, SUITE A, MARINETTE, WI 54143-1018
(715) 732-4127
(715) 732-4137
Mailing address
PO BOX 3497, STURTEVANT, WI 53177-0300
(877) 552-2996
(886) 245-8064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9832024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40426400
—
WI
Enumeration date
08/16/2006
Last updated
03/10/2008
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