Organization
WEST BEND PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY KREUSER (OWNER)
(262) 689-6853
Entity
Organization
Contact information
Practice address
279 S 17TH AVE, SUITE 3, WEST BEND, WI 53095-3001
(262) 689-6853
(262) 335-0514
Mailing address
279 S. 17TH AVENUE, SUITE 3, WEST BEND, WI 53095
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1848-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40121700
—
WI
Enumeration date
04/28/2011
Last updated
04/28/2011
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