Provider Demographics
NPI:1467904615
Name:ADVANCED HEALTH ALLIANCE LLC
Entity Type:Organization
Organization Name:ADVANCED HEALTH ALLIANCE LLC
Other - Org Name:HEALTH POINT PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-508-7550
Mailing Address - Street 1:395 N GROESBECK HWY
Mailing Address - Street 2:SUITE L
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-1542
Mailing Address - Country:US
Mailing Address - Phone:586-630-0474
Mailing Address - Fax:586-630-0476
Practice Address - Street 1:395 N GROESBECK HWY
Practice Address - Street 2:SUITE L
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-1542
Practice Address - Country:US
Practice Address - Phone:586-630-0474
Practice Address - Fax:586-630-0476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty