Provider Demographics
NPI:1235427717
Name:ADVANCED OCCUPATIONAL THERAPY SERVICES
Entity Type:Organization
Organization Name:ADVANCED OCCUPATIONAL THERAPY SERVICES
Other - Org Name:ADVANCED PHYSICAL THERAPY SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-627-0685
Mailing Address - Street 1:265 ELM DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-8275
Mailing Address - Country:US
Mailing Address - Phone:724-627-0685
Mailing Address - Fax:724-627-0849
Practice Address - Street 1:265 ELM DR
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-8275
Practice Address - Country:US
Practice Address - Phone:724-627-0685
Practice Address - Fax:724-627-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC006968L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty