# INTEGRATIVE MANUAL PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1891658837
- **Authorized official:** SUSAN M SMITH (PHYSICAL THERAPIST)
- **Authorized official phone:** (414) 510-9988

## Contact information

- **Practice address:** 285 FOREST GROVE DR STE 208, PEWAUKEE, WI 53072-3738
- **Practice address phone:** (262) 799-4090
- **Mailing address:** 285 FOREST GROVE DR STE 208, PEWAUKEE, WI 53072-3738
- **Mailing address phone:** (262) 799-4090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2025
- **Last updated:** 12/05/2025