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General NPI Number Information
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NPI Number | 1477058121
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR ADVANCED MEDICINE, PA
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 907 SE VILLAGE LOOP STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-4320
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Country | US
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Telephone | 479-268-6040
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Fax | 479-431-5098
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Provider Business Mailing Address
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Address Line | 907 SE VILLAGE LOOP STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-4320
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Country | US
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Telephone | 479-268-6040
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Fax | 479-431-5098
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. CHRISTIAN ROBERTOZZI
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Credential | PT, DPT, OCS
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Telephone | 479-402-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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