1801185962 NPI number — ADVANCED ORTHOPEDICS AND PHYSICAL THERAPY, INC.

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 1801185962 NPI number — ADVANCED ORTHOPEDICS AND PHYSICAL THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED ORTHOPEDICS AND PHYSICAL THERAPY, INC.
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:
1801185962
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4700 RICHMOND RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
WARRENSVILLE HEIGHTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44128-5984
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-378-9390
Provider Business Mailing Address Fax Number:
216-378-9379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4670 RICHMOND RD
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
WARRENSVILLE HEIGHTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44128-6410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-378-9390
Provider Business Practice Location Address Fax Number:
216-378-9379
Provider Enumeration Date:
03/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DIXON
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
216-378-9390

Provider Taxonomy Codes

  • Taxonomy code: 111NX0800X , with the licence number:  1694 , 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)





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