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Organization

ADVANCED PHYSICAL THERAPY & SPORTS MEDICINE SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAMILLA MEYER (CREDENTIALING SPECIALIST)
(920) 393-2819
Entity
Organization

Contact information

Practice address
1931 MARINETTE AVE, MARINETTE, WI 54143-3801
(715) 735-5500
(715) 735-5502
Mailing address
2105 E ENTERPRISE AVE STE 113, APPLETON, WI 54913-7862
(920) 560-1083
(920) 560-1098

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
05/31/2018
Last updated
03/26/2026
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