Organization
PRO FITNESS & REHAB, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE STEPHEN MANN III P.T. (PRESIDENT)
(262) 689-8185
Entity
Organization
Contact information
Practice address
10803 N PORT WASHINGTON RD, MEQUON, WI 53092-5085
(262) 689-8185
Mailing address
4685 COUNTY ROAD Y, SAUKVILLE, WI 53080-1117
(262) 689-8185
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1516-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41811500
—
WI
Enumeration date
05/04/2006
Last updated
06/09/2010
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