Provider Demographics
NPI:1649914912
Name:AUSTIN ATHLETIC PERFORMANCE AND RECOVERY LLC
Entity type:Organization
Organization Name:AUSTIN ATHLETIC PERFORMANCE AND RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KIHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:201-341-9119
Mailing Address - Street 1:12124 BROTEN ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-3080
Mailing Address - Country:US
Mailing Address - Phone:201-341-9119
Mailing Address - Fax:
Practice Address - Street 1:12124 BROTEN ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-3080
Practice Address - Country:US
Practice Address - Phone:201-341-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty