OrganizationActive
Advance Physical Therapy & Sports Rehab, LLC
NPI 1922363555 · Physical Therapy Clinic/Center · Beaver Dam, WI
Provider details
- NPI number
- 1922363555
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Karren Ko, Owner(920) 356-0122
- License
- 9886024 (WI)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
201 Gateway Dr Ste 300
Beaver Dam, WI 53916-9176
Phone: (920) 356-0122
Fax: (920) 356-0470
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 775
Beaver Dam, WI 53916-0775
Additional practice locations (1)
- 1626 N Spring St Ste BBeaver Dam, WI 53916-1283Phone: (920) 356-0122Fax: (920) 356-0470
Registry dates
- Enumerated
- 2012-07-10
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.