Organization
LAKELAND PHYSICAL THERAPY L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BORTON (OWNER)
(715) 239-0555
Entity
Organization
Contact information
Practice address
27477 STATE HIGHWAY 64, SUITE C, CORNELL, WI 54732-5222
(715) 239-0555
(715) 239-0556
Mailing address
27477 STATE HIGHWAY 64, SUITE C, CORNELL, WI 54732-5222
(715) 379-0916
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
10210-024
WI
273Y00000X
Rehabilitation Hospital Unit
—
—
Other
Enumeration date
03/11/2010
Last updated
07/25/2024
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