Organization
ADVANCE PHYSICAL THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMELO TENUTA OWNER (OWNER)
(262) 925-5002
Entity
Organization
Contact information
Practice address
S74W17045 JANESVILLE RD, MUSKEGO, WI 53150-9701
(414) 442-4678
(414) 442-4735
Mailing address
S74W17045 JANESVILLE RD, MUSKEGO, WI 53150-9701
(414) 442-4678
(414) 442-4735
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40381600
—
WI
Enumeration date
10/10/2013
Last updated
02/22/2018
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