Pro Fitness & Rehab, SC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1516-024 Issued in WI

Legal business name

PRO FITNESS & REHAB, SC

Practice address

10803 N Port Washington Rd
Mequon, WI 53092-5085

Phone

(262) 689-8185

NPI assigned

May 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. George Stephen Mann III, P.T.NPI 1063736627

Title

President

Phone

(262) 689-8185

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George Stephen Mann III, PT

  • Physical Therapist
  • Saukville, WI
  • NPI 1063736627
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1962450676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 COUNTY ROAD Y",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "530801117",
            "telephone_number": "262-689-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10803 N PORT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925085",
            "telephone_number": "262-689-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO FITNESS & REHAB, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-689-8185",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "1516-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41811500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela D. Powell, APNP
• Jade Prado
• Precision Radiology - Illinois LTD
• Premier Medical & Couple Therapy
• Shaunda Lillian Pride
• Amy Prout, RD
• Morgan Provo, LPC-IT, MS
• Justyna Przychocka, APNP
• Psych Affiliates Inc
• Psychological Evaluation & Consulting Services

• Physical Therapy Clinic/Center in Mequon, WI
• Providers in Mequon, WI by specialty
• Physical Therapy Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.