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General NPI Number Information
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NPI Number | 1265078596
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Entity Type | Organization
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Legal Business Name | ADVANCED PHYSICAL THERAPY TO GO LLC
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 5020 122ND STREET SUITE 200
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City | LUBBOCK
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State | TX
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Zip | 79424-8398
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Country | US
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Telephone | 806-705-7239
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Fax | 806-370-6536
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Provider Business Mailing Address
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Address Line | 12112 TOPEKA AVE
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City | LUBBOCK
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State | TX
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Zip | 79424-7677
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRADLEY VEAL
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Credential |
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Telephone | 806-239-8925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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