Provider Demographics
NPI:1447398425
Name:PHYSIOTHERAPY ASSOCIATES INC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-685-7227
Mailing Address - Street 1:2300 COIT RD
Mailing Address - Street 2:STE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3768
Mailing Address - Country:US
Mailing Address - Phone:469-467-8705
Mailing Address - Fax:267-321-2550
Practice Address - Street 1:1400 WASHINGTON ST
Practice Address - Street 2:SUITE 3
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-3043
Practice Address - Country:US
Practice Address - Phone:920-553-8993
Practice Address - Fax:920-553-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI526595Medicare Oscar/Certification