1730456567 NPI number — APT ALTERNATIVE PHYSICAL THERAPY

Table of content: (NPI 1730456567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730456567 NPI number — APT ALTERNATIVE PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APT ALTERNATIVE PHYSICAL THERAPY
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:
1730456567
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 MOUNT VERNON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WATERVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43566-1441
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-441-2191
Provider Business Mailing Address Fax Number:
419-441-2191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 MOUNT VERNON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43566-1441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-441-2191
Provider Business Practice Location Address Fax Number:
419-441-2191
Provider Enumeration Date:
11/22/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DOBRE
Authorized Official First Name:
MIHAIL
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER/CLINICIAN
Authorized Official Telephone Number:
419-441-2191

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  PT 012097 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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