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Organization
RIVERVIEW PHYSICAL THERAPY & SPORTS MEDICINE ,S.C.
Active
Organization
RIVERVIEW PHYSICAL THERAPY & SPORTS MEDICINE ,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MARY OTT PT (PRESIDENT/PHYSICAL THERAPIST)
(262) 284-9510
Entity
Organization
Contact information
Practice address
516 E GREEN BAY AVE, SAUKVILLE, WI 53080-2012
(262) 284-9510
(262) 284-9511
Mailing address
516 E GREEN BAY AVE, SAUKVILLE, WI 53080-2012
(262) 284-9510
(262) 284-9511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4345-024
WI
225100000X
Physical Therapist
6535-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40421500
—
WI
Enumeration date
10/19/2006
Last updated
08/22/2020
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