Provider Demographics
NPI:1285769034
Name:ADVANCED CARE PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:ADVANCED CARE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIMECA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:928-636-8521
Mailing Address - Street 1:411 W RD 1 NORTH
Mailing Address - Street 2:STE A
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323-0520
Mailing Address - Country:US
Mailing Address - Phone:928-636-8521
Mailing Address - Fax:928-636-8591
Practice Address - Street 1:411 W RD 1 NORTH
Practice Address - Street 2:STE A
Practice Address - City:CHINO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86323-0520
Practice Address - Country:US
Practice Address - Phone:928-636-8521
Practice Address - Fax:928-636-8591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty