Organization
ADVANTAGE PHYSICAL THERAPY & SPORTS REHAB, LLC
Active
Other names
CORA Physical Therapy - Spooner
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE KRZYMINSKI (EXECUTIVE VP)
(419) 221-6717
Entity
Organization
Contact information
Practice address
112 ASH ST STE A, SPOONER, WI 54801-1487
(715) 635-3979
(715) 635-3990
Mailing address
PO BOX 150, LIMA, OH 45802-0150
(419) 221-6717
(419) 222-0507
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100217210
—
WI
Enumeration date
03/24/2022
Last updated
02/27/2024
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