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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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