Provider Demographics
NPI:1497381164
Name:ALBANY PHYSICAL THERAPY LTD CO
Entity Type:Organization
Organization Name:ALBANY PHYSICAL THERAPY LTD CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LACY
Authorized Official - Middle Name:
Authorized Official - Last Name:VIERTEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:806-470-2858
Mailing Address - Street 1:445 KENSHALO ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:TX
Mailing Address - Zip Code:76430
Mailing Address - Country:US
Mailing Address - Phone:806-470-2858
Mailing Address - Fax:
Practice Address - Street 1:445 KENSHALO ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:TX
Practice Address - Zip Code:76430
Practice Address - Country:US
Practice Address - Phone:806-470-2858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty