Provider Demographics
NPI:1275679854
Name:ADVANCED COMPRESSION THERAPY
Entity Type:Organization
Organization Name:ADVANCED COMPRESSION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIGARAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-530-6060
Mailing Address - Street 1:720 E 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1964
Mailing Address - Country:US
Mailing Address - Phone:586-530-6060
Mailing Address - Fax:
Practice Address - Street 1:720 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-1964
Practice Address - Country:US
Practice Address - Phone:586-530-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540F336830OtherBLUE CROSS BLUE SHIELD
MI540F336830OtherBLUE CROSS BLUE SHIELD