Provider Demographics
NPI:1801185962
Name:ADVANCED ORTHOPEDICS AND PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:ADVANCED ORTHOPEDICS AND PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-378-9390
Mailing Address - Street 1:4700 RICHMOND RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5984
Mailing Address - Country:US
Mailing Address - Phone:216-378-9390
Mailing Address - Fax:216-378-9379
Practice Address - Street 1:4670 RICHMOND RD
Practice Address - Street 2:SUITE 250
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-6410
Practice Address - Country:US
Practice Address - Phone:216-378-9390
Practice Address - Fax:216-378-9379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1694111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty