Provider Demographics
NPI:1134206238
Name:ADVANCED CENTER FOR PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:ADVANCED CENTER FOR PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-275-0040
Mailing Address - Street 1:817 MERRIMACK ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-3571
Mailing Address - Country:US
Mailing Address - Phone:978-275-0040
Mailing Address - Fax:978-275-1976
Practice Address - Street 1:817 MERRIMACK ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-3571
Practice Address - Country:US
Practice Address - Phone:978-275-0040
Practice Address - Fax:978-275-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty