| NPI | 1790390102 |
|---|---|
| Doing Business As | INNOVATIVE PT |
| Entity Type | Organization |
| Authorized Contact | SHARON E COLE Owner 414-235-3660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2021-07-21 |