Provider Demographics
NPI:1649423302
Name:ADVANCED THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:ADVANCED THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLETA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-854-1955
Mailing Address - Street 1:115 E LONG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5524
Mailing Address - Country:US
Mailing Address - Phone:248-854-0050
Mailing Address - Fax:248-813-6511
Practice Address - Street 1:115 E LONG LAKE RD.,
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098
Practice Address - Country:US
Practice Address - Phone:248-854-0050
Practice Address - Fax:248-813-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty