Organization
FREEDOM PHYSICAL THERAPY SERVICES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J STATHAS PT (PRESIDENT)
(414) 352-2082
Entity
Organization
Contact information
Practice address
6908 N SANTA MONICA BLVD, FOX POINT, WI 53217-3942
(414) 352-2082
(414) 352-5279
Mailing address
6908 N SANTA MONICA BLVD, FOX POINT, WI 53217-3942
(414) 352-2082
(414) 352-5279
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40418500
—
WI
Enumeration date
09/09/2005
Last updated
10/05/2012
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