Provider Demographics
NPI:1518282474
Name:APEX PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:APEX PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LIHVARCHIK
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:623-594-9034
Mailing Address - Street 1:6320A W UNION HILLS DR
Mailing Address - Street 2:SUITE 265
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7177
Mailing Address - Country:US
Mailing Address - Phone:623-594-9034
Mailing Address - Fax:623-594-9868
Practice Address - Street 1:20045 N 19TH AVE
Practice Address - Street 2:BLDG 8
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4252
Practice Address - Country:US
Practice Address - Phone:623-594-9034
Practice Address - Fax:623-594-9868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5513225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6350280001Medicare NSC
AZZ103219Medicare PIN