Provider Demographics
NPI:1962813451
Name:ADVANCED PHYSICAL THERAPY SPECIALISTS LLC
Entity Type:Organization
Organization Name:ADVANCED PHYSICAL THERAPY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEHKING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:720-357-4079
Mailing Address - Street 1:5901 SW 74TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5150
Mailing Address - Country:US
Mailing Address - Phone:305-433-1172
Mailing Address - Fax:305-726-0003
Practice Address - Street 1:5901 SW 74TH ST STE 201
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5150
Practice Address - Country:US
Practice Address - Phone:305-433-1172
Practice Address - Fax:305-433-1172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11056225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty