Provider Demographics
NPI:1518036946
Name:ADVANTAGE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ADVANTAGE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPTA/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-657-3626
Mailing Address - Street 1:17495 AL HWY 75
Mailing Address - Street 2:
Mailing Address - City:HENAGAR
Mailing Address - State:AL
Mailing Address - Zip Code:35978
Mailing Address - Country:US
Mailing Address - Phone:256-657-3626
Mailing Address - Fax:256-657-3623
Practice Address - Street 1:17495 AL HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:HENAGAR
Practice Address - State:AL
Practice Address - Zip Code:35978-5629
Practice Address - Country:US
Practice Address - Phone:256-657-3626
Practice Address - Fax:256-657-3623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty