Healthcare Provider Details

I. General information

NPI: 1104940899
Provider Name (Legal Business Name): ALLIED PHYSICAL THERAPY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 11/08/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALLIED PHYSICAL THERAPY, P.A. 1469 SW 4TH TERRACE
CAPE CORAL FL
33991-1424
US

IV. Provider business mailing address

ALLIED PHYSICAL THERAPY, P.A. 1469 SW 4TH TERRACE
CAPE CORAL FL
33991-1424
US

V. Phone/Fax

Practice location:
  • Phone: 239-242-0070
  • Fax: 239-242-0076
Mailing address:
  • Phone: 239-242-0070
  • Fax: 239-242-0076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number0700056666
License Number StateFL

VIII. Authorized Official

Name: MR. MATTHEW K HARKNESS
Title or Position: PRESIDENT
Credential: DPT
Phone: 239-242-0070