Provider Demographics
NPI:1790390102
Name:COLE REHAB ENTERPRISES LLC
Entity Type:Organization
Organization Name:COLE REHAB ENTERPRISES LLC
Other - Org Name:INNOVATIVE PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:414-235-3660
Mailing Address - Street 1:8800 S 102ND ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-7712
Mailing Address - Country:US
Mailing Address - Phone:414-235-3660
Mailing Address - Fax:
Practice Address - Street 1:8800 S 102ND ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-7712
Practice Address - Country:US
Practice Address - Phone:414-448-3009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty