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

Advanced Physical Therapy & Sports Medicine SC

Organization Physical Medicine & Rehabilitation Physician · NPI 1407857790

Advanced Physical Therapy & Sports Medicine SC is a Physical Medicine & Rehabilitation Physician in Appleton, Wisconsin. Registered with an NPI since 2005.

In the registry since
2005
Specialties on file
3

Practice location Address checks out

2105 E Enterprise Ave # 113 Advanced Physical Therapy
Appleton, WI 54913-7862
Phone: (920) 991-2561
Fax: (920) 991-2563
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X
Physical Therapy Clinic/Center Taxonomy 261QP2000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1407857790
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Camilla Meyer — Credentialing Specialist · (920) 393-2819
NPI enumeratedAugust 9, 2005
Last updated in NPPESMarch 10, 2026
Certification dateMarch 10, 2026
Mailing address2105 E Enterprise Ave Ste 113, Appleton, WI 54913-7862

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