Provider Demographics
NPI:1629434089
Name:ATHLETIC AND PHYSICAL THERAPY SERVICES INC.
Entity Type:Organization
Organization Name:ATHLETIC AND PHYSICAL THERAPY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PREDIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUKEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT, OCS
Authorized Official - Phone:304-253-7246
Mailing Address - Street 1:423 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2805
Mailing Address - Country:US
Mailing Address - Phone:304-253-7246
Mailing Address - Fax:304-253-7250
Practice Address - Street 1:423 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2805
Practice Address - Country:US
Practice Address - Phone:304-253-7246
Practice Address - Fax:304-253-7250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty