Organization
BACK-IN-ACTION PHYSICAL THERAPY CENTER OF KENOSHA, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY DENISE SOLECKI (BUSINESS MANAGER)
(262) 925-9000
Entity
Organization
Contact information
Practice address
6123 GREEN BAY RD, STE 140, KENOSHA, WI 53142-2927
(262) 564-8334
(262) 653-9264
Mailing address
PO BOX 158, KENOSHA, WI 53141-0158
(262) 653-9208
(262) 653-9264
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6483024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3907B3699000
BCBS OF WI
—
Enumeration date
09/20/2005
Last updated
08/22/2020
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