Living Well Physical Therapy, LLC
Organization Active NPI Physical Therapist · Whitefish Bay, WI
NPI 1740925635 · NPPES record last updated Jul 5, 2024
Key facts
- NPI
- 1740925635
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- LIVING WELL PHYSICAL THERAPY, LLC
- Practice address
- 159 E Silver Spring Dr
Whitefish Bay, WI 53217-4703 - Phone
- (262) 770-5025
- NPI assigned
- May 4, 2022
- Organization subpart
- No
Authorized official
- Name
- Dr. Stephanie Lynn Patek, DPT
- Title
- Owner/Provider
- Phone
- (414) 312-3180
Practitioners 3
-
Ashley Martin-Metcalf, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240326001014 | WI | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 0749627768 |
Receives reassigned benefits from 2 practitioners Practice locations: Franklin, WI; Whitefish Bay, WI |
National Provider Directory
Locations
11217 W Forest Home Ave
Ste 1
Franklin, WI 53132
Phone (262) 770-5025
11217 W Forest Home Ave
Franklin, WI 53132
Phone (262) 770-5025
159 E Silver Spring Dr
Whitefish Bay, WI 53217
Phone (262) 770-5025
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Physical Therapy Clinic/Center | 261QP2000X |
Addresses
Primary practice location
159 E Silver Spring Dr
Whitefish Bay, WI 53217-4703
Mailing address
4634 N Sheffield Ave
Whitefish Bay, WI 53211-1106
Phone (414) 312-3180
Other practice location 1
11217 W Forest Home Ave
Franklin, WI 53132-1272
Phone (262) 770-5025
Other providers in Whitefish Bay, WI
- Laura Kunkel
- Gordon Edward Lang
- Sukeun Lee
- Dante Lehman
- Elissa Lenkin
- Lmbpt LLC
- Longevity Community Services Inc
- Longevity Holistic Wellness LLC
- Lorraine Pagel, DDS SC
- Heather Lukach
All providers in Whitefish Bay, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.