Organization
ELITE PHYSICAL THERAPY AND REHAB SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA M VANAACKEN PT,DPT,OCS,CSCS (CO-OWNER)
(920) 231-5195
Entity
Organization
Contact information
Practice address
300 S KOELLER ST, SUITE G, OSHKOSH, WI 54902-5590
(920) 231-5195
(920) 231-5196
Mailing address
PO BOX 3497, STURTEVANT, WI 53177-0300
(877) 552-2996
(262) 898-8696
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
6434-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40424800
—
WI
Enumeration date
08/14/2006
Last updated
03/07/2008
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