Provider Demographics
NPI:1245363597
Name:ADVANCED MOTION THERAPEUTIC MASSAGE,INC
Entity type:Organization
Organization Name:ADVANCED MOTION THERAPEUTIC MASSAGE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOMER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMBIGADIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS,OTRL
Authorized Official - Phone:772-567-8585
Mailing Address - Street 1:2965 20TH STREET
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960
Mailing Address - Country:US
Mailing Address - Phone:772-567-8585
Mailing Address - Fax:772-299-7868
Practice Address - Street 1:2965 20TH STREET
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-567-8585
Practice Address - Fax:772-299-7868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty