=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730456567
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APT ALTERNATIVE PHYSICAL THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/22/2011
-----------------------------------------------------
Last Update Date | 11/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 MOUNT VERNON DR
-----------------------------------------------------
City | WATERVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43566-1441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-441-2191
-----------------------------------------------------
Fax | 419-441-2191
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 MOUNT VERNON DR
-----------------------------------------------------
City | WATERVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43566-1441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-441-2191
-----------------------------------------------------
Fax | 419-441-2191
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER/CLINICIAN
-----------------------------------------------------
Name | MIHAIL DOBRE
-----------------------------------------------------
Credential | P.T.
-----------------------------------------------------
Telephone | 419-441-2191
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | PT 012097
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------