Provider Demographics
NPI:1518993971
Name:AUGUSTA PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:AUGUSTA PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:REITZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:540-887-8007
Mailing Address - Street 1:424 COMMERCE RD
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-4432
Mailing Address - Country:US
Mailing Address - Phone:540-887-8007
Mailing Address - Fax:540-908-3901
Practice Address - Street 1:424 COMMERCE RD
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-4432
Practice Address - Country:US
Practice Address - Phone:540-887-8007
Practice Address - Fax:540-908-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2000X
VA0119000914261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09892Medicare PIN