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Organization
SPORT CLINIC PHYSICAL THERAPY INC
Active
Organization
SPORT CLINIC PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A HENDRICKSON PT (OWER PRESIDENT)
(414) 351-5794
Entity
Organization
Contact information
Practice address
8911 N PORT WASHINGTON RD, SPORT CLINIC PHYSICAL THERAPY INC, BAYSIDE, WI 53217-1634
(414) 351-5794
(414) 351-2770
Mailing address
8911 N PORT WASHINGTON RD, SPORT CLINIC PHYSICAL THERAPY INC, BAYSIDE, WI 53217-1634
(414) 351-5794
(414) 351-2770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40424700
—
WI
Enumeration date
08/10/2006
Last updated
06/12/2012
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