Provider Demographics
NPI:1356665855
Name:ADVANCE THERAPEUTICS INC.
Entity Type:Organization
Organization Name:ADVANCE THERAPEUTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:413-584-7234
Mailing Address - Street 1:60 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1205
Mailing Address - Country:US
Mailing Address - Phone:413-584-7234
Mailing Address - Fax:413-584-1896
Practice Address - Street 1:60 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1205
Practice Address - Country:US
Practice Address - Phone:413-584-7234
Practice Address - Fax:413-584-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8037225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty