| Lakes Area Physical Therapy, Llc | |
|
800 Geneva Pkwy N, Suite 3, Lake Geneva, WI 53147-5701 | |
| (262) 248-9902 | |
| (262) 248-9419 |
| Full Name | Lakes Area Physical Therapy, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 800 Geneva Pkwy N, Lake Geneva, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588845804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 4467024 (Wisconsin) | Primary |
| Provider Name | John R Van Susteren |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619192150 PECOS PAC ID: 6305738253 Enrollment ID: I20120605000716 |
| Mailing Address | Practice Location Address |
|---|---|
| Lakes Area Physical Therapy, Llc 800 Geneva Pkwy N, Suite 3, Lake Geneva, WI 53147-5701 Ph: (262) 248-9902 | Lakes Area Physical Therapy, Llc 800 Geneva Pkwy N, Suite 3, Lake Geneva, WI 53147-5701 Ph: (262) 248-9902 |
Erin E Mahoney, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Geneva Pkwy N, Lake Geneva, WI 53147 Phone: 262-249-3500 | |
Matthew Allen Hoffman, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Geneva Pkwy N, Lake Geneva, WI 53147 Phone: 262-249-3500 | |
Madalyn R Douglas, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-4980 Fax: 262-245-2248 | |
Kelly J Pauley, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 | |
Kimberly K Dama, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 | |
Mrs. Tara M. Grocholski, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Geneva Pkwy N, Lake Geneva, WI 53147 Phone: 262-249-3500 | |
Carling M. Johns, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 800-638-2901 Fax: 262-245-2248 |