Organization Name: | ATHLETIC ADVANTAGE, INC |
NPI Number: | 1336341973 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK A READ (OWNER) |
Mailing Address: | 8849 Whitney Dr Lewis Center |
State: | OH US |
Postal Code: | 430357107 |
Phone Number: | 7405497041 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251S0007X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Sports |
Taxonomy Definition: |