Provider Demographics
NPI:1265658090
Name:INSTEP PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:INSTEP PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LABISCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:414-858-9306
Mailing Address - Street 1:5700 S 108TH ST
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-1911
Mailing Address - Country:US
Mailing Address - Phone:414-858-9306
Mailing Address - Fax:414-858-9307
Practice Address - Street 1:5700 S 108TH ST
Practice Address - Street 2:
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-1911
Practice Address - Country:US
Practice Address - Phone:414-858-9306
Practice Address - Fax:414-858-9307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3460024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000046415Medicare PIN
WI000001573Medicare ID - Type Unspecified