ADVANCED THERAPY GROUP, LLC

Provider Demographics

• NPI: 1326391137
• Name: ADVANCED THERAPY GROUP, LLC
• Entity Type: Organization
• Organization Name: ADVANCED THERAPY GROUP, LLC
• Authorized Official - Title/Position: THERAPIST
• Authorized Official - Prefix: MRS
• Authorized Official - First Name: SARA
• Authorized Official - Last Name: DEVAUN
• Authorized Official - Credentials: DPT
• Authorized Official - Phone: 231-421-9201
• Mailing Address - Street 1: 812 S GARFIELD AVE
• Mailing Address - Street 2: SUITE 1
• Mailing Address - City: TRAVERSE CITY
• Mailing Address - State: MI
• Mailing Address - Zip Code: 49686-3456
• Mailing Address - Country: US
• Mailing Address - Phone: 231-421-9201
• Mailing Address - Fax: 231-421-9193
• Practice Address - Street 1: 812 S GARFIELD AVE
• Practice Address - Street 2: SUITE 1
• Practice Address - City: TRAVERSE CITY
• Practice Address - State: MI
• Practice Address - Zip Code: 49686-3456
• Practice Address - Country: US
• Practice Address - Phone: 231-421-9201
• Practice Address - Fax: 231-421-9193
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2012-10-17
• Last Update Date: 2017-07-11

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	2251N0400X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Neurology	Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	2251H1300X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Human Factors	Group - Multi-Specialty
No	2251X0800X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Orthopedic	Group - Multi-Specialty
No	225200000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapy Assistant		Group - Multi-Specialty
No	225700000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Massage Therapist		Group - Multi-Specialty
No	225X00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist		Group - Multi-Specialty
No	225XE0001X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Environmental Modification	Group - Multi-Specialty
No	225XE1200X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Ergonomics	Group - Multi-Specialty
No	225XH1200X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Hand	Group - Multi-Specialty
No	225XH1300X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Human Factors	Group - Multi-Specialty
No	225XL0004X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Low Vision	Group - Multi-Specialty
No	225XM0800X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Mental Health	Group - Multi-Specialty
No	225XN1300X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Neurorehabilitation	Group - Multi-Specialty
No	225XP0019X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Physical Rehabilitation	Group - Multi-Specialty