Provider Demographics
NPI:1962819367
Name:ADVANCE THERAPY, INC.
Entity Type:Organization
Organization Name:ADVANCE THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BELLEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR
Authorized Official - Phone:970-223-2923
Mailing Address - Street 1:1125 W DRAKE RD
Mailing Address - Street 2:UNIT B8
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6031
Mailing Address - Country:US
Mailing Address - Phone:970-214-1388
Mailing Address - Fax:
Practice Address - Street 1:2768 NOTTINGHAM SQ
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2589
Practice Address - Country:US
Practice Address - Phone:970-223-2923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty