Provider Demographics
NPI:1881759686
Name:ACCELERATED PHYSICAL THERAPY AND OCCUPATIONAL HEALTH, INC
Entity type:Organization
Organization Name:ACCELERATED PHYSICAL THERAPY AND OCCUPATIONAL HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CAPO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:228-463-9030
Mailing Address - Street 1:PO BOX 3497
Mailing Address - Street 2:
Mailing Address - City:BAY ST LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39521-3497
Mailing Address - Country:US
Mailing Address - Phone:228-463-9030
Mailing Address - Fax:228-463-0103
Practice Address - Street 1:833 HIGHWAY 90 STE 2
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-1601
Practice Address - Country:US
Practice Address - Phone:228-463-9030
Practice Address - Fax:228-463-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT1744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty