Organization
GATEWAY THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY K KORB DPT (PHYSICAL THERAPIST)
(414) 305-8946
Entity
Organization
Contact information
Practice address
547 N 62ND ST, WAUWATOSA, WI 53213-4169
(414) 305-8946
Mailing address
547 N 62ND ST, WAUWATOSA, WI 53213-4169
(414) 305-8946
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
10827-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194991018
—
WI
Enumeration date
04/28/2011
Last updated
04/28/2011
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