Organization
ADVANCE THERAPY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA J KING (OFFICE MANAGER)
(920) 233-7177
Entity
Organization
Contact information
Practice address
976 E JOHNSON ST, STE. 100, FOND DU LAC, WI 54935-9746
(920) 322-9128
Mailing address
3475 OMRO RD, STE. 300, OSHKOSH, WI 54904-7125
(920) 233-7177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3756-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41219900
—
WI
Enumeration date
05/22/2007
Last updated
08/22/2020
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