Provider Demographics
NPI:1659919942
Name:AXIS PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:AXIS PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:STEFEN
Authorized Official - Last Name:ZWIRN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-873-2003
Mailing Address - Street 1:4013 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1001
Mailing Address - Country:US
Mailing Address - Phone:813-873-2003
Mailing Address - Fax:813-873-2042
Practice Address - Street 1:4013 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1001
Practice Address - Country:US
Practice Address - Phone:813-873-2003
Practice Address - Fax:813-873-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies