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NPI Code Detail

MEDICARE: ADVANCED THERAPY NOW INC

MEDICARE: ADVANCED THERAPY NOW INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist2098NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215109202
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED THERAPY NOW INC
Provider Business Mailing Address
First Line : 2012 WHITE CLOUD ST NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-3717
Country : US
Telephone Number : 505-573-4472
Fax Number : 505-212-0521
Provider Business Practice Location Address
First Line : 1024 EUBANK BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-5310
Country : US
Telephone Number : 505-573-4472
Fax Number : 505-212-0521
Authorized Official
Title or Position : PRESIDENT
Name : MS. KALYA B COTKIN
Credential : OTR
Telephone Number : 505-573-4472
Provider Enumeration Date : 03/31/2008
Last Update Date : 04/01/2008

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Directions to “ADVANCED THERAPY NOW INC ” Practice Location

Language Start Address Practice Location
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