Provider Demographics
NPI:1346894656
Name:CORNERSTONE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:CORNERSTONE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-226-1446
Mailing Address - Street 1:2829 COUNTY HIGHWAY I STE 3
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-2678
Mailing Address - Country:US
Mailing Address - Phone:715-723-4451
Mailing Address - Fax:715-723-5712
Practice Address - Street 1:2829 COUNTY HIGHWAY I STE 3
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-2678
Practice Address - Country:US
Practice Address - Phone:715-723-4451
Practice Address - Fax:715-723-5712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy