Provider Demographics
NPI:1477946150
Name:ADVANCE MOBILITY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ADVANCE MOBILITY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:ROWENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAMPLONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-990-5544
Mailing Address - Street 1:24488 SUSSEX HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-8470
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24488 SUSSEX HWY STE 2
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-8470
Practice Address - Country:US
Practice Address - Phone:302-990-5544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty