| NPI | 1033277553 |
|---|---|
| Doing Business As | ADVANCED SPINE AND SPORT REHABILITATION |
| Entity Type | Organization |
| Authorized Contact | THOMAS D VAN DE WATER Managing Partner 262-884-6418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2024-01-13 |