Healthcare Provider Details

I. General information

NPI: 1316963762
Provider Name (Legal Business Name): APEX PHYSICAL THERAPY, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 09/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 N 2ND ST
BREESE IL
62230-1650
US

IV. Provider business mailing address

15 APEX DR
HIGHLAND IL
62249-1282
US

V. Phone/Fax

Practice location:
  • Phone: 618-526-7801
  • Fax: 618-526-7901
Mailing address:
  • Phone: 618-651-0444
  • Fax: 618-654-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: MR. BRADLEY R PFITZNER
Title or Position: CEO PRESIDENT
Credential: OTR/L
Phone: 618-651-0444