Provider Demographics
NPI:1073021333
Name:ALPHA PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:ALPHA PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JOURJY
Authorized Official - Last Name:GREISS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:331-200-1205
Mailing Address - Street 1:3 TORI CT
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6392
Mailing Address - Country:US
Mailing Address - Phone:331-200-1205
Mailing Address - Fax:
Practice Address - Street 1:3 TORI CT
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-6392
Practice Address - Country:US
Practice Address - Phone:331-200-1205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy