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Organization
ULTIMATE PERFORMANCE THERAPY, LLC
Active
Organization
ULTIMATE PERFORMANCE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY JAMES RUPNOW PT, DPT, LAT (DOCTOR OF PHYSICAL THERAPY - MEMBER)
(608) 333-8504
Entity
Organization
Contact information
Practice address
403 VENTURE CT, SUITE 2, VERONA, WI 53593
(608) 333-8504
Mailing address
403 VENTURE CT, SUITE 2, VERONA, WI 53593
(608) 333-8504
(608) 338-0525
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6515-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40349800
—
WI
Enumeration date
02/01/2012
Last updated
02/01/2012
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