Provider Demographics
NPI:1912050618
Name:ADVANCED ORTHOPAEDIC PHYSICAL THERAPY, PSC
Entity Type:Organization
Organization Name:ADVANCED ORTHOPAEDIC PHYSICAL THERAPY, PSC
Other - Org Name:PARROTT & ASSOCIATES, P.S.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:WAITS
Authorized Official - Last Name:SNOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MHS, OCS
Authorized Official - Phone:502-412-4486
Mailing Address - Street 1:9400 WILLIAMSBURG PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5093
Mailing Address - Country:US
Mailing Address - Phone:502-412-4486
Mailing Address - Fax:502-412-4490
Practice Address - Street 1:9400 WILLIAMSBURG PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5093
Practice Address - Country:US
Practice Address - Phone:502-412-4486
Practice Address - Fax:502-412-4490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYDA4916OtherRAILROAD MEDICARE
KY000000071328OtherANTHEM
KY000000071328OtherANTHEM