Healthcare Provider Details

I. General information

NPI: 1336467661
Provider Name (Legal Business Name): ADVANCED CENTER FOR PHYSICAL THERAPY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WESTINGHOUSE DR STE 200
CRANBERRY TOWNSHIP PA
16066-5238
US

IV. Provider business mailing address

PO BOX 392573
PITTSBURGH PA
15251-9573
US

V. Phone/Fax

Practice location:
  • Phone: 724-584-5739
  • Fax:
Mailing address:
  • Phone: 724-448-2733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateVA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1336155845
Identifier TypeOTHER
Identifier StateVA
Identifier IssuerNPI

VIII. Authorized Official

Name: LAUREN LAU
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 724-989-4564