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Sports Physical Therapy & Rehab Specialist Sc

Clinic/Center in Union Grove, WI · enumerated 2018 · authorized official Juana Granados, Credentialing Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1417455528

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Registry record

Entity type Organization (Type 2)
Legal business name Sports Physical Therapy & Rehab Specialist Sc
Other name <Unavail>
Practice address 1201 Main St, Union Grove, WI, 53182
Phone (262) 878-9602
Fax (262) 878-9609
Enumeration date Jan 24, 2018
Last updated in NPPES Apr 6, 2018

Taxonomy & classification

225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
261Q00000X Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Juana Granados
Title Credentialing Manager
Phone (630) 575-1980

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Sports Physical Therapy & Rehab Specialist Sc?
The NPI for Sports Physical Therapy & Rehab Specialist Sc is 1417455528, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Sports Physical Therapy & Rehab Specialist Sc?
NPPES lists Juana Granados (Credentialing Manager) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-04-06.