Provider Demographics
NPI:1467208165
Name:ATX TOTAL THERAPY PLLC
Entity type:Organization
Organization Name:ATX TOTAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:BUSCAGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:704-500-4879
Mailing Address - Street 1:4407 MARATHON BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3428
Mailing Address - Country:US
Mailing Address - Phone:704-500-4879
Mailing Address - Fax:
Practice Address - Street 1:4407 MARATHON BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3428
Practice Address - Country:US
Practice Address - Phone:704-500-4879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty