Provider Demographics
NPI:1437221892
Name:PHYSICAL THERAPY SPECIALISTS AND CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SPECIALISTS AND CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:608-348-4070
Mailing Address - Street 1:150 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53818
Mailing Address - Country:US
Mailing Address - Phone:608-348-4070
Mailing Address - Fax:608-348-4071
Practice Address - Street 1:150 MARKET STREET
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818
Practice Address - Country:US
Practice Address - Phone:608-348-4070
Practice Address - Fax:608-348-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3625024225100000X
WI4833024225100000X
WI5327024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40420700Medicaid