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General NPI Number Information
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NPI Number | 1588143952
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Entity Type | Organization
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Legal Business Name | ADVANCED PHYSIQUE SOLUTIONS, LLC
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 920 WESTCOTT ST. #507
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City | HOUSTON
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State | TX
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Zip | 77007-7700
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Country | US
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Telephone | 347-682-1894
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Fax |
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Provider Business Mailing Address
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Address Line | 920 WESTCOTT ST APT 507
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City | HOUSTON
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State | TX
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Zip | 77007-6367
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Country | US
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Telephone | 347-682-1894
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Fax |
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Authorized Official
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Title or Position | CLINICAL EXERCISE PHYSIOLOGIST
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Name | ALICIA MAI
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Credential | RCEP
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Telephone | 347-682-1894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number | 74234673
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License Number State | TX
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