Organization
FUSION PHYSICAL THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN M NOVAK DPT (DOCATORATE PHYSICAL THERAPY)
(414) 412-8072
Entity
Organization
Contact information
Practice address
N49W6693 WESTERN RD, CEDARBURG, WI 53012-1804
(414) 412-8072
Mailing address
PO BOX 170826, MILWAUKEE, WI 53217-8076
(414) 412-8072
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
10888-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659565133
—
WI
Enumeration date
12/09/2013
Last updated
12/09/2013
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