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Organization

LAKES AREA PHYSICAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN R VAN SUSTEREN (PHYSICAL THERAPIS / OWNER)
(262) 248-9902
Entity
Organization

Contact information

Practice address
800 GENEVA PKWY N, SUITE 3, LAKE GENEVA, WI 53147-5701
(262) 248-9902
(262) 248-9419
Mailing address
800 GENEVA PKWY N, SUITE 3, LAKE GENEVA, WI 53147-5701
(262) 248-9902
(262) 248-9419

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4467024
WI

Other

Enumeration date
11/15/2007
Last updated
04/07/2010
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