Provider Demographics
NPI:1477058121
Name:INSTITUTE FOR ADVANCED MEDICINE, PA
Entity Type:Organization
Organization Name:INSTITUTE FOR ADVANCED MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:479-402-9400
Mailing Address - Street 1:907 SE VILLAGE LOOP STE 5
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4320
Mailing Address - Country:US
Mailing Address - Phone:479-268-6040
Mailing Address - Fax:479-431-5098
Practice Address - Street 1:907 SE VILLAGE LOOP STE 5
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4320
Practice Address - Country:US
Practice Address - Phone:479-268-6040
Practice Address - Fax:479-431-5098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy