Organization
IDEAL PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG PETER FERNANDEZ PT (PHYSICAL THERAPIST)
(414) 232-8382
Entity
Organization
Contact information
Practice address
N69W5289 COLUMBIA RD, CEDARBURG, WI 53012-2156
(414) 232-8382
Mailing address
N69W5289 COLUMBIA RD, CEDARBURG, WI 53012-2156
(414) 232-8382
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/27/2019
Last updated
12/27/2019
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