Provider Demographics
NPI:1639791338
Name:AMERICAN MOBILE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:AMERICAN MOBILE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VALTER
Authorized Official - Middle Name:ROBERTO
Authorized Official - Last Name:CIPOLLARI
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:256-776-7215
Mailing Address - Street 1:125 OLD IVEY CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-3484
Mailing Address - Country:US
Mailing Address - Phone:256-347-4014
Mailing Address - Fax:
Practice Address - Street 1:125 OLD IVEY CIR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-3484
Practice Address - Country:US
Practice Address - Phone:256-776-7215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy