Organization
BACK ON TRACK PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL JOHNSTON PT (OWNER)
(262) 366-9340
Entity
Organization
Contact information
Practice address
W359N5002 BROWN ST, SUITE B, OCONOMOWOC, WI 53066-3366
(262) 560-4200
Mailing address
1622 TALLGRASS CIRCLE, WAUKESHA, WI 53188
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/15/2006
Last updated
08/22/2020
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