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General NPI Number Information
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NPI Number | 1912252651
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Entity Type | Organization
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Legal Business Name | ADVANCED THERAPY SOLUTIONS
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 7264 ARGUS DR
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City | ROCKFORD
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State | IL
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Zip | 61107-5837
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Country | US
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Telephone | 181-563-3681
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 EDELWEISS RD
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City | ROCKFORD
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State | IL
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Zip | 61109-2406
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Country | US
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Telephone | 181-521-8361
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Fax |
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Authorized Official
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Title or Position | THERAPY PROGRAM DIRECTOR
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Name | MS. LISA MARIE HARTMANN
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Credential | MOTR/L, BSRS
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Telephone | 18152183618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 05600853
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License Number State | IL
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