Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Advance Physical Therapy and Sports Rehab, LLC

Organization Physical Therapy Clinic/Center · NPI 1780022525

Advance Physical Therapy and Sports Rehab, LLC is a Physical Therapy Clinic/Center in Beaver Dam, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2013.

Licensed in
WI
In the registry since
2013
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1626 N Spring St Ste B
Beaver Dam, WI 53916-1283
Phone: (920) 356-0122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X · Licence 12384-24 (WI)

Record details

NPI number1780022525
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jim Ko — Business Manager · (920) 356-0122
NPI enumeratedJune 13, 2013
Last updated in NPPESJune 13, 2013
Mailing addressPo Box 775, Beaver Dam, WI 53916-0775

Other providers in Beaver Dam