Organization Name: | ADVANCE PHYSICAL THERAPY & SPORTS REHAB. INC |
NPI Number: | 1093954158 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARIAN CUBA RUTA (PRESIDENT) |
Mailing Address: | 3411 Olandwood Ct Suite 106 Olney |
State: | MD US |
Postal Code: | 208321488 |
Phone Number: | 2407509966 |
Fax Number: | 3017741336 |
NPI Enumeration Date: | 02/12/2009 |
NPI Last Update Date: | 04/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 18214 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |