| Crysta Clark, DPT | |
|
240 Maple Ave, Mukwonago, WI 53149-8475 | |
| (262) 928-1715 | |
| (262) 363-1918 |
| Full Name | Crysta Clark |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 240 Maple Ave, Mukwonago, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992315287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 15117 (Wisconsin) | Primary |
| Provider Name | Advantage Physical Therapy & Sports Rehab, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1881773463 PECOS PAC ID: 8022016336 Enrollment ID: O20061121000412 |
| Mailing Address | Practice Location Address |
|---|---|
| Crysta Clark, DPT 240 Maple Ave, Mukwonago, WI 53149-8475 Ph: (262) 928-1715 | Crysta Clark, DPT 240 Maple Ave, Mukwonago, WI 53149-8475 Ph: (262) 928-1715 |
Ms. Kathryn L. Hammer, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 955 Main St Ste Cd, Mukwonago, WI 53149 Phone: 262-662-9760 Fax: 262-662-9761 | |
One-on-one Physical Therapy, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 503 Minors Dr, Mukwonago, WI 53149 Phone: 414-640-2372 Fax: 262-363-5227 | |
Jacey J Mroczenski, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1231 S Rochester St Ste 210, Mukwonago, WI 53149 Phone: 262-710-9100 | |
Ms. Rose Lillian Hebar, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 727 County Road Nn E, Mukwonago, WI 53149 Phone: 262-363-3014 Fax: 262-363-3019 | |
Lisa A Stefl, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 240 Maple Ave, Mukwonago, WI 53149 Phone: 262-928-1909 Fax: 262-363-1918 | |
Mrs. Joanne Elizabeth Jessen, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 240 Maple Ave, Mukwonago, WI 53149 Phone: 262-928-1909 Fax: 262-363-1918 | |
Kyla Galles, BS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1231 S Rochester St Ste 210, Mukwonago, WI 53149 Phone: 262-710-9100 Fax: 262-363-7798 |