Provider Demographics
NPI:1588956882
Name:ATLANTIC PHYSICAL THERAPY GROUP PA LLC
Entity type:Organization
Organization Name:ATLANTIC PHYSICAL THERAPY GROUP PA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-271-4100
Mailing Address - Street 1:1208 TASKER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1019
Mailing Address - Country:US
Mailing Address - Phone:215-271-4100
Mailing Address - Fax:215-271-1785
Practice Address - Street 1:1208 TASKER ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-1019
Practice Address - Country:US
Practice Address - Phone:215-271-4100
Practice Address - Fax:215-271-1785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty