Provider Demographics
NPI:1487871430
Name:TRI-MOTION REHAB LLC
Entity type:Organization
Organization Name:TRI-MOTION REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAGA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CSCS, CKTP
Authorized Official - Phone:262-754-1650
Mailing Address - Street 1:W307N1499 GOLF RD
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2129
Mailing Address - Country:US
Mailing Address - Phone:262-754-1650
Mailing Address - Fax:262-754-0877
Practice Address - Street 1:W307N1499 GOLF RD
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2129
Practice Address - Country:US
Practice Address - Phone:262-754-1650
Practice Address - Fax:262-754-0877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10229-024261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI68269Medicare UPIN