Organization
MURISON SPORTS MEDICINE AND REHABILITATION, LLC
Active
Organization
MURISON SPORTS MEDICINE AND REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE MURISON DPT (PHYSICAL THERAPIST)
(414) 614-8778
Entity
Organization
Contact information
Practice address
230 N WALWORTH AVE, UNIT 4, WILLIAMS BAY, WI 53191-9201
(414) 614-8778
Mailing address
PO BOX 610, SILVER LAKE, WI 53170-0610
(414) 614-8778
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
12724
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K100219239
MEDICARE PTAN
WI
Enumeration date
04/13/2015
Last updated
10/13/2022
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