MEDICARE: ADVANCED PHYSICAL THERAPY 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
1	225100000X	Physical Therapist

Other Identifiers

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

General Provider Information

NPI Number	:	1699779041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PHYSICAL THERAPY INC.

Provider Business Mailing Address
First Line	:	1005 N MAIN ST
Second Line	:
City	:	MITCHELL
State	:	SD
Zip	:	57301-1351
Country	:	US
Telephone Number	:	605-996-4552
Fax Number	:	605-996-0577

Provider Business Practice Location Address
First Line	:	1005 N MAIN ST
Second Line	:
City	:	MITCHELL
State	:	SD
Zip	:	57301-1351
Country	:	US
Telephone Number	:	605-996-4552
Fax Number	:	605-996-0577

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPIST
Name	:	MR. JEFFREY A LEE
Credential	:	MPT
Telephone Number	:	605-996-4552

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	01/14/2008

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