OrganizationActive
Advantage Physical Therapy & Sports Rehab, LLC
NPI 1104497023 · Rehabilitation Clinic/Center · Salem, WI
Provider details
- NPI number
- 1104497023
- Entity type
- Organization
- Primary specialty
- Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Steve Krzyminski, Exec. Vp(419) 221-6717
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7137 236th Ave Ste 101
Salem, WI 53168-8975
Phone: (262) 925-5060
Fax: (262) 925-5061
Street-level locationGet directions
Mailing address
Po Box 150
Lima, OH 45802-0150
Other names (DBA / former)
- Doing business as
- Cora Physical Therapy - Paddock Lake
- Doing business as
- Cora Physical Therapy - Paddock Lake
Registry dates
- Enumerated
- 2021-07-02
- Last updated
- 2024-02-27
- Certified
- 2024-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.