Provider Demographics
NPI:1306104070
Name:THE CENTER FOR ADVANCED THERAPY
Entity type:Organization
Organization Name:THE CENTER FOR ADVANCED THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANTLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-358-6501
Mailing Address - Street 1:635 MCQUEEN SMITH ROAD
Mailing Address - Street 2:SUITE D
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066
Mailing Address - Country:US
Mailing Address - Phone:334-358-6501
Mailing Address - Fax:334-358-6521
Practice Address - Street 1:635 MCQUEEN SMITH ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066
Practice Address - Country:US
Practice Address - Phone:334-358-6501
Practice Address - Fax:334-358-6521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3196283XC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283XC2000XHospitalsRehabilitation HospitalChildren