Provider Demographics
NPI:1346081163
Name:JUNIPER PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:JUNIPER PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WERGIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:920-320-9838
Mailing Address - Street 1:1011 S 10TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-5209
Mailing Address - Country:US
Mailing Address - Phone:920-320-9838
Mailing Address - Fax:920-264-9665
Practice Address - Street 1:1011 S 10TH ST STE 104
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-5209
Practice Address - Country:US
Practice Address - Phone:920-320-9838
Practice Address - Fax:920-264-9665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy