Provider Demographics
NPI:1295472017
Name:ADVANCED PHYSICAL THERAPY SERVICES, LTD
Entity Type:Organization
Organization Name:ADVANCED PHYSICAL THERAPY SERVICES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:OERTWIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-661-8823
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61702-0047
Mailing Address - Country:US
Mailing Address - Phone:309-661-8823
Mailing Address - Fax:309-661-8001
Practice Address - Street 1:1201 E BROADWAY STE C
Practice Address - Street 2:
Practice Address - City:MONMOUTH
Practice Address - State:IL
Practice Address - Zip Code:61462-1995
Practice Address - Country:US
Practice Address - Phone:309-734-1103
Practice Address - Fax:309-734-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy