Provider Demographics
NPI:1295923308
Name:INTEGRATED PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:INTEGRATED PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSSPRUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, LAT, CSCS
Authorized Official - Phone:608-658-5352
Mailing Address - Street 1:4834 MORRIS CT
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-9163
Mailing Address - Country:US
Mailing Address - Phone:608-658-5352
Mailing Address - Fax:888-965-4018
Practice Address - Street 1:313 JUNCTION RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2613
Practice Address - Country:US
Practice Address - Phone:608-658-5352
Practice Address - Fax:888-965-4018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy