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General NPI Number Information
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NPI Number | 1427054980
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Entity Type | Organization
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Legal Business Name | ADVANCED PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 724 W MAIN ST STE 180
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City | LEWISVILLE
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State | TX
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Zip | 75067-3583
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Country | US
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Telephone | 972-434-6024
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Fax | 972-434-2784
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Provider Business Mailing Address
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Address Line | 724 W MAIN ST STE 180
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City | LEWISVILLE
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State | TX
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Zip | 75067-3583
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Country | US
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Telephone | 972-434-6024
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Fax | 972-434-2784
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MR. SCOTT FREDERICK MCGOUGH
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Credential | PT
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Telephone | 972-434-6024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 532820000
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 632910000
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License Number State | TX
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