Organization
ELLEFSON THERAPY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARMELO D. TENUTA PT (PRESDENT/CEO)
(262) 657-0222
Entity
Organization
Contact information
Practice address
1425 SUMMIT AVE STE 201, WAUKESHA, WI 53188-3200
(262) 542-1112
(262) 542-7476
Mailing address
1425 SUMMIT AVE STE 201, WAUKESHA, WI 53188-3200
(262) 542-1112
(262) 542-7476
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40412900
—
WI
Enumeration date
10/10/2006
Last updated
02/15/2008
Update your record
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