Organization
VISITING PHYSICAL THERAPISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP WILLIAM BERGOLD PT (OWNER)
(414) 940-7278
Entity
Organization
Contact information
Practice address
6072 S MEADOW CT, CUDAHY, WI 53110-3410
(414) 940-7278
(414) 769-1808
Mailing address
PO BOX 371031, MILWAUKEE, WI 53237-2131
(414) 940-7278
(414) 769-1808
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5058
WI
Other
Enumeration date
12/09/2009
Last updated
12/09/2009
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