Provider Demographics
NPI:1114684933
Name:NISSENBAUM AND SCHLEUSNER PRO PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:NISSENBAUM AND SCHLEUSNER PRO PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB-BUFFINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-841-1290
Mailing Address - Street 1:6649 UNIVERSITY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3021
Mailing Address - Country:US
Mailing Address - Phone:608-841-1290
Mailing Address - Fax:608-841-1299
Practice Address - Street 1:711 RETHKE AVE STE 1
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-1404
Practice Address - Country:US
Practice Address - Phone:608-841-1290
Practice Address - Fax:608-841-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty