1013169473 NPI number — ADVANCED CENTER FOR PHYSICAL THERAPY, PLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013169473 NPI number — ADVANCED CENTER FOR PHYSICAL THERAPY, PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED CENTER FOR PHYSICAL THERAPY, PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013169473
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 392573
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15251-9573
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-584-5739
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5928 SEMINOLE TRL
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
BARBOURSVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22923-2831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-985-2198
Provider Business Practice Location Address Fax Number:
434-985-3227
Provider Enumeration Date:
10/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
LAU
Authorized Official First Name:
LAUREN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CREDENTIALING
Authorized Official Telephone Number:
724-989-4564

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  8658 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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